PBM Reform Now

Congress must take meaningful action to implement transparency, accountability, and reform in the pharmacy benefit manager (PBM) industry. Comprehensive PBM reform is critical to protect the free market, expand patient access to lower-priced generics and biosimilars, and prevent disparities.  

 

PBM reform should include: full transparency for plan sponsors; hold PBMs accountable the same way employers are accountable; require that all rebates and discounts go to employers and patients; reform group purchasing organizations and specialty pharmacies tied to big PBMs; ban spread pricing; de-link PBM fees from the price of drugs; implement technology that backs data sharing with patients, insurers, pharmacists, and other stakeholders; and ensure patients have access to the most affordable and appropriate medications.

 

PBM reform has the potential to save billions of dollars, leading to more affordable drug costs and more affordable insurance for workers and families. Now more than ever, Congress should advance these policies through the legislative process so that fair market competition can be had in the prescription drug supply chain.