Public awareness is rapidly intensifying about the harmful role pharmacy benefit managers (PBMs) play in driving up prescription drug costs and denying consumers access to vitally needed medications. These powerful middlemen have come under increasing scrutiny from policymakers and regulators, with the Federal Trade Commission (FTC) taking decisive action this year by filing a complaint against the largest PBMs for anticompetitive and unfair practices and issuing a groundbreaking interim report about their anticompetitive practices. These practices are not just unfair; they’re forcing consumers to pay unnecessarily high prices for the medications they rely on.
If some PBMs hope that a business-friendly second Trump administration will give this small handful of giant corporations that control 90% of the prescription drug marketplace a reprieve, they are sorely mistaken. The first Trump administration reversed the laissez-faire approach to PBMs. And the recent appointments of the new FTC chairman and commissioner are further indications of the continued commitment to address monopolistic PBM practices, creating even more opportunities to hold these harmful middlemen accountable. Trump 2.0 is likely to be giving the PBMs some doses of regulatory medicine they certainly don’t want. In fact, on Monday, he told reporters, “We’re going to knock out the middleman.”
And it’s just not the administration and regulators that PBMs should be worried about. This week, congressional leaders have a crucial opportunity to enact significant PBM reform aimed at curbing PBM monopolistic practices including delinking prices from profits. Numerous hearings have underscored the urgency, notably revealing instances where PBM executives were caught lying to Congress. Immediate action is vital to address these deceptive behaviors and to ensure transparency and fairness in drug pricing.
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