Pharmacy Benefit Managers (PBMs) are companies hired by health insurers to manage prescription drug programs. But, as middlemen on the prescription drug supply chain who develop formularies, PBM’s have used their position as price negotiators to keep all savings for themselves.

The three largest PBMs alone processed 80% of the prescriptions filled in the United States. Last year they made nearly half of a trillion dollars doing it – without providing any benefit to patients.  

The ACR applauds Congress for recent landmark reforms to increase transparency and reform the business practices of PBMs within Medicare and Medicaid as a first step to lowering prescription drug prices. Now, it is crucial that Congress acts to regulate the actions of PBMs within commercial insurance plans.

The ACR needs you to urge your lawmakers to:

• Support the PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act (H.R. 6837/S. 3549) to amend the Employee Retirement Income Security Act of 1974 (ERISA) to treat PBMs as fiduciaries, requiring them to place the interests of the health plan and its participants ahead of the PBM’s financial interests. 
• Pass the PBM Transparency Act (S. 526) to ban spread pricing and require PBMs to report spread pricing and pharmacy fee profits to the Federal Trade Commission (FTC). 
• Support the DRUG Act (H.R. 2214) to replace PBM fees based on the prices they negotiate for drugs with flat service fees and require 100% rebate pass through.

Act now to let Congress know that reforming PBMs in the commercial market is necessary to lower the prices of prescription drugs! 

The ACR’s Legislative Action Center will allow you to contact your members of Congress with just a few clicks. Take a moment to send your letter today!