This article accompanies a primer on pharmacy benefit managers from June 2025. You can read more here.
There is widespread, bipartisan belief across the country that prescription drug costs are too high. So, why won’t Congress get serious about lowering costs and reforming one of the most influential players in the drug supply chain, pharmacy benefit managers (PBMs)?
PBMs, the middlemen of the drug supply chain, were originally created to streamline things for their customers (health insurers) and negotiate to save them money. In turn, insurers could ideally pass on those savings to patients in the form of lower premiums and cost-sharing. However, PBMs have increasingly put their own profits over patients. In recent years, Congress (and numerous presidents) have floated policies that would limit PBMs’ influence over the supply chain and overall costs. Yet, they have failed to pass significant legislation that reins them in.
I wrote about this problem this week for Public Health Post, summarizing how PBMs siphon savings away from American patients while Congress sits back and watches. I go on to suggest a few national reforms that Congress should pass this session, many of which have already been successful at the state-level.
You can read the full piece here.
