Two experts on pharmacy benefit managers and contract transparency have accepted our request to testify at the interim hearing Friday, Feb. 15, before the House Government Reform and Pensions & Investments committees. 

 

David Balto, a partner with Robins, Kaplan, Miller & Ciresi LLP in Washington, D.C., testified for us at a Senate interim hearing, also about pharmacy benefit managers. He has practiced antitrust law for more than 20 years both in the Antitrust Division of the Department of Justice, the Federal Trade Commission, and private practice.

David counsels a wide variety of health care companies including pharmaceutical manufacturers, medical device manufacturers, specialty pharmaceutical distributors, health care systems, and pharmacy chains. His counseling includes antitrust and consumer protection compliance, FDA regulation, strategic alliances, distribution issues, mergers and joint ventures. He has testified before Congress and the FTC on health care competition issues.

 

Gerry Purcell assists states, cities, and private plans in selecting and contracting with the best PBM, negotiating optimal contracts with pharmacies and drug manufacturers, selecting benefit designs, maximizing rebate strategies and rebate migration, auditing, and litigation strategies. He assesses PBM business practices and the potential financial damages and overcharges as a result of their practices. He has evaluated hundreds of plan sponsor agreements, thousands of pages of PBM documents to include agreements with drug manufacturers and network pharmacies, and collaborated with the top PBM consultants and auditors in the United States for the purpose of developing a baseline model to determine potential overcharges.

Gerry is frequently asked to testify before federal and state legislative bodies. He has briefed Department of Justice attorneys and more than a dozen attorneys generals on the subject of pharmacy benefits, and evaluated their respective state programs. He has worked extensively in support of the multi-state attorneys generals litigation regarding reimbursement of Medicaid claims, including Texas.

 

Gerry's efforts, along with other full-disclosure
advocates, are yielding substantial savings and recoveries for clients and are beginning to change PBM practices nationally.

Prior to working in the PBM industry and forming Pharmacy Partners, Gerry worked in the managed care industry with Kaiser Permanente.