cover of episode Legislators Introduce Bipartisan Bills to Break Up Drug Middlemen

Legislators Introduce Bipartisan Bills to Break Up Drug Middlemen

2024/12/11
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Alex Ossola
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Harriet Torrey
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Joe Hoppe
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Liz Esley Whyte
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Mariah Timms
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Alex Ossola: 本期节目主要报道了FBI局长克里斯托弗·雷在总统大选前辞职,两党议员提出的旨在拆分药房福利管理机构(PBM)的法案,以及11月份通货膨胀上升对美联储的影响。还报道了其他新闻,包括两家大型超市运营商之间的法律纠纷,两名顶级房地产经纪人被捕,以及咖啡价格上涨等。 Harriet Torrey: 11月份消费者物价指数上涨,表明消费者支出强劲,通货膨胀依然存在,尤其是在住房和医疗服务等领域。尽管如此,美联储和投资者对通货膨胀趋势总体持乐观态度,预计美联储将在12月降息。但商品价格的回升是美联储需要关注的潜在风险。特朗普政府的政策也可能加剧通货膨胀。 Liz Esley Whyte: 两党议员提出的法案旨在拆分药房福利管理机构(PBM),迫使拥有保险公司或PBM的公司出售其药房业务。这将对CVS Health、Cigna和UnitedHealth Group等公司造成重大打击。该法案旨在解决PBM的激励机制问题,防止患者被引导到利润更高的邮购药房。PBM改革多年来一直是两党关注的焦点,这项法案是迄今为止对PBM最广泛的干预。 Mariah Timms: 前总统特朗普试图将自己从佐治亚州的案件中移除,理由是总统豁免权。案件的未来尚不确定,可能面临撤销指控或推迟到2029年再审理的可能性。案件长期搁置对起诉方不利,但如果现任检察官继续负责,并且获得批准,案件仍然有可能恢复进展。 Joe Hoppe: 阿拉比卡咖啡豆价格今年上涨超过80%,达到历史新高,主要原因是巴西遭遇了70多年来最严重的干旱,以及越南罗布斯塔咖啡豆产量的下降。 Alex Ossola: This episode covers FBI Director Christopher Wray's resignation before the presidential inauguration, bipartisan bills aimed at breaking up Pharmacy Benefit Managers (PBMs), and the impact of rising inflation in November on the Federal Reserve. Other news includes a legal dispute between two major supermarket operators, the arrest of two top real estate agents, and rising coffee prices.

Deep Dive

Key Insights

Why are legislators introducing bills to break up pharmacy benefit managers (PBMs)?

The bills aim to address the perceived perverse incentives in the PBM industry, such as steering patients to mail-order pharmacies that benefit the PBMs financially, leading to higher costs for consumers.

What are the key proposals in the bipartisan bills targeting PBMs?

The legislation would force companies that own both insurers and PBMs to sell off their pharmacy businesses, including retail, mail-order, and specialty pharmacies, affecting major players like CVS Health, Cigna, and UnitedHealth Group.

What role do pharmacy benefit managers (PBMs) play in the healthcare system?

PBMs create formularies, prioritize drugs for specific diseases, and negotiate discounts and rebates on drugs, aiming to save employers and consumers money by securing better deals on medications.

How could the proposed legislation impact PBMs and consumers?

If passed, the legislation could end practices like steering patients to mail-order pharmacies that benefit PBMs financially, potentially reducing costs for consumers and eliminating conflicts of interest.

What does the bipartisan support for PBM reform indicate about its chances of passing?

The bipartisan support suggests growing interest in addressing healthcare costs and populist concerns, increasing the likelihood that Congress may finally pass significant PBM reform legislation.

What was the key finding in the November inflation report?

The consumer price index rose 2.7% year-over-year and 0.3% month-over-month, marking the strongest monthly increase since April, driven by higher vehicle prices and persistent inflation in housing and services.

How might the November inflation data influence the Federal Reserve's decisions?

The data shows persistent inflation, particularly in services, which the Fed has been trying to contain. While the trend is encouraging, the Fed will monitor rising goods prices, which could complicate their efforts to bring inflation back to target.

Why have coffee prices surged to record highs?

Coffee prices, particularly for Arabica beans, have surged due to severe droughts and heavy rains in Brazil, the largest exporter of Arabica, and reduced production in Vietnam, the largest Robusta producer, leading to supply concerns.

Chapters
Legislators introduced bipartisan bills aiming to break up pharmacy benefit managers (PBMs). This would be the most significant intervention in PBM operations to date, addressing concerns about high drug costs and potential conflicts of interest. The success of these bills remains uncertain, although bipartisan support suggests a possibility of progress.
  • Bipartisan bills introduced in Senate and House to reform PBMs
  • Legislation would force companies owning insurers or PBMs to divest pharmacy businesses
  • Aims to address concerns about high drug costs and potential conflicts of interest
  • Significant bipartisan support, but past attempts failed

Shownotes Transcript

Translations:
中文

FBI Director Christopher Wray is stepping down before President-elect Donald Trump takes office.

And lawmakers have introduced bills that, if approved, would be the most far-reaching intervention yet into the operations of pharmacy benefit managers. PBM reform has been a big bipartisan issue for years now. It almost got done at the end of last year and didn't quite get across the finish line.

It definitely seems like there are more and more people interested in harnessing this populist rage against the cost of health care. Plus, U.S. inflation ticked up last month. What does that mean for the Fed? It's Wednesday, December 11th. I'm Alex Osola for The Wall Street Journal. This is the PM edition of What's News, the top headlines and business stories that move the world today.

Inflation was up in November. The consumer price index rose 2.7 percent from a year earlier, the Labor Department said this morning. That's up 0.3 percent from the prior month, the strongest month-over-month increase since April. Here to tell us more about what these numbers mean is Wall Street Journal economics reporter Harriet Torrey. So, Harriet, this report follows other data that suggests that consumers are feeling pretty upbeat.

And though inflation is down from a few years ago, it's still at a level that's kind of difficult for people. So what does this report say about consumer spending? It shows that consumers are continuing to spend pretty strongly, and that is reflected in prices. We saw some pretty notable increases in the CPI in November last

For instance, vehicle prices ticked up. Now that was probably impacted by hurricanes and people replacing cars that were damaged. But it could also be a sign that consumers are trying to get ahead of tariffs. And there are other increases in other sectors. The index for housing cooled ever so slightly, and that's positive for the Fed because they do want to see a cooling. But it is nonetheless still pretty persistent inflation in housing and in other services like medical care services.

So by and large, the trend is pretty encouraging from the Fed and investors are very convinced. Fed funds futures suggest that they expect a cut at the next meeting in December. But at the same time, there are definitely some things that the Fed needs to be looking out for in this report. We saw that goods, which have generally been on quite a major downswing over the past couple of years, goods have been

Goods prices appear to be reversing a little bit. And we've seen a few months now of core commodity prices ticking higher. The trend is somewhat bumpy, but that is definitely something that the Fed is going to want to watch out for, because by and large, a lot of the inflation that they've been battling hard to contain has been in services. And now that seems to be balancing out somewhat. So the thinking is that this data doesn't necessarily change inflation.

the expected cut that's supposed to come from the Fed next week. Right. But what people will be looking for very closely is what the Fed signals about the year ahead, because this last mile of inflation is proving very sticky and persistent. And it's something that some of the proposed policies that the Trump administration has said it wants to enact, like worker deportations, tariffs, tax cuts,

Economists say those things could all prove inflationary, so it could make the Fed's battle to bring down inflation back to target ever harder. That was Wall Street Journal economics reporter Harriet Torrey. Major U.S. indexes rose, buoyed by the inflation report. The Nasdaq crossed 20,000 for the first time, gaining about 2%. The S&P 500 gained about 1%, while the Dow closed down about 0.2%.

America's two biggest supermarket operators have gone from deal partners to legal rivals in less than 24 hours. Albertson's is terminating its planned sale to Kroger. The company also filed a lawsuit alleging that Kroger didn't do enough to secure regulatory approval for the company's $20 billion deal. The suit comes a day after a federal court blocked the sale. A Kroger spokeswoman said that Albertson's claims are baseless and without merit, and that Kroger is evaluating its options.

Two of the country's top real estate agents and their brother have been arrested in Florida on sex trafficking charges. Tal and Oren Alexander and their brother Alon are expected to be extradited to New York. An attorney temporarily representing the three brothers said his clients were facing three sex trafficking-related charges. The arrests follow a number of lawsuits accusing them of rape, allegations that sent shockwaves through the luxury real estate world when they first surfaced. The men have denied the allegations.

Coming up, legislators introduce bills that could break up drug middlemen in the health care industry. That's after the break. Imagine this. A workforce so adaptable, it can pivot whenever your business pivots. A supply chain that can handle the pressure. And a sales team that can not only predict what your next year will look like, but can actually be right. That's the power of SAP Business AI.

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A bipartisan group of lawmakers has introduced legislation that would break up pharmacy benefit managers, the drug middlemen that have now faced years-long scrutiny. If passed, bills introduced in the Senate and House would be the most far-reaching intervention yet into the operations of pharmacy benefit managers, or PBMs. Wall Street Journal reporter Liz Esley-White joins us from Washington to tell us more. Liz, what are legislators proposing here?

Legislators are proposing that any company that owns an insurer or a pharmacy benefit manager, so there are three big ones that fit this bill, and they would be forced to sell off their pharmacy businesses. So this is any retail pharmacies in addition to mail order or specialty pharmacies.

And that would be a big blow to CVS Health, Cigna, and UnitedHealth Group. Tell me a little bit more about these pharmacy benefit managers. What do they do exactly?

If you look at a map of what PBMs do, it's like a spaghetti bowl. It's very complicated. But among other things, they will come up with formularies, which are drugs typically that have priority for each disease. They have some kind of favorite drugs that they've gotten a good deal on for their clients, and they will negotiate discounts for those drugs.

And so their contention is that they end up saving employers and other people money because they're doing all these deals to get these good rebates on these drugs for the formularies. So what would change for them if this legislation passes?

One of the things that they've been accused of doing is they will charge a lot more for drugs that come through their mail order pharmacies. They all have these kind of affiliated mail order pharmacies and they can encourage the people using them to use the mail order pharmacy and

that can end up steering more dollars into their pocket and having patients end up paying more for their drugs. So the senators and the House sponsors feel that this would put an end to those kind of tied-up incentives and that the steering of patients to mail-order pharmacies that make more money for these PBMs would end.

So this is a bipartisan bill introduced into the Senate by Democrat Elizabeth Warren and Republican Josh Hawley. What does that tell us about the likelihood that this legislation could pass? Yeah, PBM reform has been a big bipartisan issue for years now. It almost got done at the end of last year and didn't quite get across the finish line. It definitely seems like there are more and more people interested in harnessing this

populist rage against the cost of health care. And so maybe we'll see Congress finally move the needle. In addition to this bill, there have been other bills proposed that would ban certain pricing practices that PBMs use or require more transparency from PBM transactions. So we'll have to see what ends up crossing the finish line. But this is definitely the biggest aim at some of what the legislators are calling perverse incentives that we've seen so far. That was Wall Street Journal reporter Liz Esley White.

FBI Director Christopher Wray is stepping down after President-elect Donald Trump made clear he would fire him in favor of a loyalist. Trump chose Wray for the post in 2017, but the former president soured on him and the bureau more broadly after years of federal investigations into his conduct. Trump's breaking point with Wray came in August 2022 after a team of FBI agents conducted an unprecedented search of his Mar-a-Lago residence in search of classified documents.

Before Donald Trump won the election, he was facing a number of state and federal lawsuits. Now, many of those have been dropped or shelved, except a suit from the state of Georgia alleging that Trump operated a criminal enterprise aimed at overturning the result of the 2020 election. But the case has been sidelined all year, and its future is uncertain. National Legal Affairs correspondent Mariah Timms joins us. Mariah, where could the case go from here?

First up, former President Trump has moved to remove himself from the case. He has argued that because he is about to be president again, questions of presidential immunity are likely to mean he cannot be prosecuted while he's in office. It's not clear what immediate next steps would be taken on that.

But it's possible that the court system could decide to drop all charges against him, could move to hold the charges against him until 2029 when he ends his term and try to pick them up again later. But likely the rest of this case is going to move forward without him in the short term. It seems like even without that 2029 delay, it's been pretty slow going so far. Is that good news or bad news for the prosecution?

Mostly it's bad news if a case sits around for this long. The case has been tied up in appeals. There are questions over whether they will disqualify the current prosecutor from the case. And then that would possibly go to a state board, which, again, a lot of ifs here would decide whether to move forward or not with it.

The problem with sitting on cases is the same in any case. Witnesses, their memory fades. They might change their testimony. Evidence is no longer as useful as it was in the past. But that doesn't mean they couldn't rebuild the momentum. This case had four plea deals in quick succession. There was a sense that they were moving forward with people wanting to cooperate with the prosecution. So it is possible that if this case stays with the current prosecutor, it could be picked up again when they get the go-ahead to go there. That was National Legal Affairs correspondent Mariah Timms.

Well, as Harriet was saying earlier, commodity prices are up. One of the places caffeine addicts might be feeling it is in their morning cup of joe. Prices for Arabica coffee beans, one of the two main varieties of coffee, the other being Robusta, have jumped more than 80% this year, reaching an all-time high.

WSJ Commodities reporter Joe Hoppe explains what's behind this price surge in the enormous coffee market. It's actually one of the world's most traded commodities. It's often, according to Saxo Bank at the very least, considered the second most traded by volume after crude oil. The price for a pound of Arabica coffee beans have actually topped their previous record, which was set in 1977. To put that into perspective, the last time coffee was this expensive, the first Star Wars movie was in theatres.

The main reason that has been driving up the price comes back down to weather. Brazil has been hit by its worst drought in more than 70 years over the late summer, followed by a series of heavy rains which have raised crop failure fears. Brazil is the largest exporter of Arabica worldwide. The prices of Arabica and Robusta are pretty closely linked.

Generally speaking, whenever there's a shortfall or a price surge in one of these, you'll see a price surge in the other one as well. And so Robusta has also gone up very heavily in price. So Vietnam is the largest producer of Robusta in the world, but it's also had a much lower production this year, hit by its own droughts and heavy rains. Because of that, that's created a larger reliance on Brazilian harvests themselves in short supply.

And that's What's News for this Wednesday afternoon. Today's show was produced by Anthony Bansi and Pierre Bien-Aimé with supervising producer Michael Kosmides. I'm Alex Osola for The Wall Street Journal. We'll be back with a new show tomorrow morning. Thanks for listening.

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