AMCP's Adam Colborn on the Real-World Impacts of Drug Pricing Legislation

Adam Colborn, JD, associate vice president of Congressional Affairs at AMCP, spoke to the need for policymakers to approach drug pricing reform holistically, as well as the role that pharmacists can play in advocating for policies to improve medication access.

Transcript

What do you think policymakers might be missing about the real-world impact of drug pricing legislation on patients and health care providers?

I think policymakers miss quite a bit when it comes to drug pricing, and I think the main issue there is that drug pricing is extremely complex. Every step of the process has downstream impacts, so you can't make a change without expecting it to have impacts on the other stakeholders. And that's not just stakeholders within one segment of the pharmacy industry, right? If you make a change to manufacturers, that's going to have an impact on insurers, and that's going to have an impact on pharmacies themselves. And so what most concerns me about the current discussion that we see in [Washington,] DC, is that they seem to be viewing each step of the supply chain in a vacuum, and they're paying really very little attention to how a particular change, no matter how well intentioned it is, will shift incentives and behaviors for all of the actors in the market.

Since the Inflation Reduction Act passed and has begun to be implemented, the common refrain that we've heard is "unintended consequences." One example that I'll give is after the Medicare Drug Price Negotiation Program, prices for the initial year of 2026 for those selected drugs, when those prices were announced, we saw a lot of community and retail pharmacies say that they may not stock those drugs because the negotiated prices caused a reduction in the reimbursement rate that the pharmacy receives for dispensing that drug. And, you know, I don't know if that's true. They've argued that it's an unsustainable price, which may be the case, but we know that lots of low-cost drugs are dispensed currently, so it's to be determined on how that bears out. But regardless of whether that's an accurate description or not, we may end up in the reality that the Drug Price Negotiation Program, which was intended to make drugs more affordable for patients, has actually reduced access because now pharmacies don't stock the drugs.

Ultimately I think Congress needs to move very cautiously, and they need to take a holistic approach to drug pricing and consider the whole supply chain. The current piecemeal approach that we're using right now may eventually lead us to a better system, but I think there will be a lot of avoidable pain along the way, unless we take a step back and look at the big picture.

What role do you think pharmacists can play in advocating for policies that ensure affordable drug pricing for vulnerable populations?

I think pharmacists, regardless of setting, have a very important role to play as the subject matter experts on pharmacy care, so whether they're working in a community hospital or managed care setting, you know, they have a much better view of how the system works in practice than policymakers who are juggling dozens or sometimes hundreds of different issues. So what I would say to pharmacists is that I encourage them to connect with their elected officials at both the state and federal levels. We see things move much more quickly at the state level, and so that's very important as well. But regardless of what level of elected official, they have expertise that would be good to share.

I would say you can always call or email your officials, particularly those who serve in DC, but district offices back home are often overlooked, so dropping by the district office in person to have a conversation with the staff there about pending legislation can make a really big difference. And not only because the pharmacist is an expert and a health care provider, but they're also a constituent and a voter, and that carries a lot of weight with elected officials.