In Washington, Congress did not take any action this spring to regulate the operations of pharmacy benefit managers (PBMs), despite the efforts of legislative bodies to address issues related to PBMs. The Pharmaceutical Care Management Association, the largest trade group for PBMs, significantly increased its lobbying spending by 71% from $2.8 million to $4.8 million in the first three months of the year, indicating that they were seeking to maintain their influence in Congress.
Despite the challenges faced by PBMs as intermediaries between drugmakers and health insurers, there were initiatives in Congress aimed at increasing transparency and reforming how they function in various sectors. The House passed a package focused on transparency, while Senate committees passed reforms for PBMs in Medicaid, Medicare, and commercial insurance markets. Additionally, public health programs required funding in a government spending bill, allowing members of Congress to avoid voting on individual issues.
However, due to the lack of action by Congress, PBMs continued operating without additional regulations. The industry’s lobbyists worked tirelessly to maintain their status quo and prevent any significant changes from occurring. Despite these efforts, it is clear that Congress needs to take action if it wants to address the concerns surrounding PBMs and ensure that patients have access to affordable prescription drugs.
