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New Senate Bill Targets PBM Consumer Abuses

Lawmakers blame pharmacy benefit managers for high drug prices, introducing a bill to prevent what they term unfair practices.

Lawmakers are turning up the heat on pharmacy benefit management (PBM) companies. Last week, the US Senate tabled a bill authorizing the Federal Trade Commission (FTC) to crack down on PBM practices that are supposedly unfair to consumers. The Pharmacy Benefit Manager Transparency Act of 2022 would ban PBMs from:

  • Charging an insurer more for processing a prescription than it reimburses the pharmacy for the product, a practice known as “spread pricing”;
  • Clawing back reimbursement payments to pharmacies via direct remuneration fees; and
  • “Unfairly charging pharmacies more to offset federal reimbursement changes.”

PBMs would also have to report any monies they get from such practices and be subject to enforcement from the FTC and state attorneys general.

“Pharmacy benefit managers and other intermediaries in the pharmaceutical supply chain must be held accountable for increasing the cost of healthcare in the United States,” noted Sen. Chuck Grassley, R-Iowa, one of the bill’s co-sponsors (along with Sen. Maria Cantwell, D-Washington).