High drug pricing has been a rare target for bipartisanship in the new Congress, with Republicans and Democrats giving early focus to PBMs -- third-party administrators that function as intermediaries between insurance companies and consumers.
"I think both Republicans and Democrats, as they learn more, can certainly kind of come to agreement on that, you know, markets work based on transparency,” said Wayne Winegarden, senior fellow in business and economics at the Pacific Research Institute. “Well, here you have middlemen creating all sorts of opacity. That’s problematic, and I think that's something that left- or right-of-center people can agree that markets don't work when prices aren't transparent.
Lawmakers have proposed several bipartisan policies to address the matter. Sens. Chuck Grassley and Maria Cantwell reintroduced the Pharmacy Benefit Manager Transparency Act of 2023, which aims to increase drug pricing transparency by empowering the Federal Trade Commission and state attorney to stop"unfair and deceptive PBM business practices,""Opaque middlemen and anti-competitive practices have resulted in unacceptably high prescription drug prices.
Republicans have also used their oversight authority to review PBM practices, as well as oversee pricing controls on prescription drugs for Medicare beneficiaries set in the newly enacted Inflation Reduction Act. The House Committee on Oversight and Accountability investigation has called on the largest PBMs — CVS Caremark, Express Scripts, and OptumRx — that control roughly 80% of the market to provide documentation to justify their practices.
"The Inflation Reduction Act is an attempt to slap on controls in order to fix a real problem when the actual problem is that the market is not functioning properly," said Winegarden."The better way to approach it is, you know, fix the market problem, find out what was structurally wrong, and fix it.”
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