Congress Advances Measures to Curb Powerful PBM Industry with Bipartisan Support

By Consumers for Quality Care, on December 6, 2023

The House Committee on Energy and Commerce health subcommittee recently advanced 21 proposals, some aimed at curbing the power of pharmacy benefit managers (PBMs), Fierce Healthcare reports.

These proposals included the Protecting Patients Against PBM Abuses Act, which seeks to uncouple PBM compensation from medication costs, ban spread pricing, and ensure fair reimbursement for network pharmacies.

Both Democrats and Republicans are supporting measures meant to rein in the PBM industry, highlighting concerns about their influence on drug prices, increasing their profits at the detriment of consumers. The dominance of three major PBMs—CVS Caremark, Optum Rx, and Express Scripts—within the industry also raise concerns about market control.

During the committee meeting, Congresswoman Anna Eshoo (D-CA) said “I don’t think they [PBMs] do a thing for patients,” adding that the three major PBMs account for nearly 80 percent of all prescription drug claims reported $400 billion collectively in revenue last year.

CQC urges lawmakers and regulators to continue to scrutinize PBM practices that increase the cost of prescription medications for consumers.