Rep. Earl L. “Buddy” Carter (R-GA) has introduced the PBM Reform Act, aiming to protect patients and pharmacies from certain business practices of pharmacy benefit managers (PBMs). The bill is supported by 11 bipartisan members of Congress.
“It’s time to bust up the PBM monopoly, which has been stealing hope and health from patients for decades,” said Rep. Carter. He emphasized that transparency, competition, and accountability are key components of the reform package.
The proposed legislation seeks to ban “spread pricing” in Medicaid, establish new requirements under Medicare Part D, promote transparency in prescription drug plans, and enforce contract terms in Medicare Part D pharmacy contracts.
Original co-sponsors include Debbie Dingell (D-MI), Greg Murphy (R-NC), Deborah Ross (D-NC), Jodey Arrington (R-TX), Diana Harshbarger (R-TN), Vicente Gonzalez (D-TX), Rick Allen (R-GA), Raja Krishnamoorthi (D-IL), John Rose (R-TN), Derek Tran (D-CA), and Nicole Malliotakis (R-NY).
“For too long, pharmacy benefit managers have been allowed to operate unchecked,” stated Rep. Debbie Dingell. She highlighted issues such as rising prices and restricted access to medications due to PBM practices.
Rep. Greg Murphy added that unaffordable healthcare and unclear pricing practices create barriers for Americans. He pointed out that PBMs obscure drug costs at the expense of patients.
Rep. Deborah Ross expressed concern over unregulated middlemen driving up medication prices: “Nobody should have to choose between paying for life-saving medication and putting food on the table.”
The legislation aims to address these concerns by increasing transparency and lowering costs for families while providing relief for local pharmacies facing financial difficulties.
Background information reveals that three companies control 80% of the prescription drug market due to consolidation among PBMs, resulting in higher costs for patients nationwide.
