A bipartisan group of lawmakers has introduced a bill that would break up some of the nation’s biggest healthcare conglomerates by forcing them to sell off their retail or mail-order pharmacies. The legislation, which targets “pharmacy benefit managers” (P.B.M.s) – companies hired by employers and government programs to oversee prescription drug benefits, aims to reduce their control over the market.
The three largest P.B.M.s – CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth’s Optum Rx – collectively control 80% of prescriptions in the US. Critics argue that these companies prioritize their own interests, driving up costs for employers and government programs while harming small pharmacies.
Senator Elizabeth Warren (D-MA) claims that P.B.M.s have manipulated the market to enrich themselves, hiking up drug costs and cheating employers. The bill would force companies like CVS Health, Cigna, and UnitedHealth to divest their pharmacy businesses within three years if enacted.
Pharmacy benefit managers’ lobbying group, Pharmaceutical Care Management Association, argues that they help patients access prescription drugs conveniently and affordably. However, spokespeople for CVS and Express Scripts have warned against policies that would increase the cost of medicine in the US and potentially hand out benefits to the pharmaceutical industry.
The bill’s success is uncertain, as similar legislation has stalled in Congress despite bipartisan support. Lawmakers on both sides aim to take on the issue, but the powerful healthcare lobbies continue to resist changes.
Source: https://www.nytimes.com/2024/12/11/business/warren-hawley-pharmacy-benefit-managers.html