WASHINGTON — Under mounting pressure to address soaring health care costs, Senate Finance Committee leaders said Wednesday they are preparing a renewed push to regulate the drug industry’s most controversial middlemen: pharmacy benefit managers.
During a hearing focused on health care affordability, Committee Chair Mike Crapo (R-Idaho) said he and ranking member Ron Wyden (D-Ore.) are finalizing legislation that will be reintroduced “in the coming days.” The plan targets pharmacy benefit managers, or PBMs — companies hired by insurers and large employers to negotiate drug prices and manage prescription benefits.
PBMs have become lightning rods in the national debate over drug affordability. Pharmaceutical manufacturers accuse them of distorting the market through opaque rebate deals and pocketing savings instead of passing them on to consumers. PBMs, in turn, argue that they help keep prices in check and that drugmakers are responsible for setting excessively high list prices.
Crapo said the goal is to bring more transparency and oversight to a part of the drug supply chain that “too often operates in the shadows.”
Wyden echoed that sentiment, saying that families “deserve straight answers” about how much of their prescription spending is driven by behind-the-scenes negotiations. “There is bipartisan appetite for reform,” he said, pointing to long-standing frustration from both parties over rising medication costs.
The upcoming bill is expected to revive several proposals the committee had advanced previously, including requirements for PBMs to disclose rebate contracts, limits on spread pricing, and new standards to ensure that negotiated savings benefit patients directly at the pharmacy counter.
Industry lobbyists, patient advocates, and executives from major health plans are expected to weigh in as the legislation moves forward — setting up a new round of clashes over one of Washington’s most entrenched and expensive policy battles.
With drug affordability emerging as a top concern for voters heading into the next election year, lawmakers signaled that PBM reform will be a central focus of the committee’s agenda. “We have an obligation to tackle the drivers of high drug prices wherever they are found,” Crapo said. “That includes the middlemen.”
