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The PBM Accountability Project members and partners are highlighting a shared concern: PBMs and vertically integrated insurers are creating real barriers to patient affordability and access. Watch new video testimonials underscoring the urgent need for meaningful PBM reform: Emma Freer, Senior Health Policy Analyst, American Economic Liberties Project How has vertical integration in the health insurance industry affected patient choice, medication access and drug pricing fai

Each year, premiums go up, deductibles increase, and insurers and their affiliated PBMs make record profits. In recent years, investigations and hearings have been uncovering how this happens. During a 2025 congressional hearing on PBM practices, Witness Dr. Hugh Chancy, a Georgia pharmacist and former president of the National Community Pharmacists Association, described a story of a customer whose prescription cost $135 at the pharmacy – yet their insurance plan was bille

The U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee traveled to Louisiana recently for field hearings focused on improving healthcare affordability. The hearings brought together patients, providers and local experts to discuss the growing challenges facing communities across the country. Throughout the hearing, witnesses described a healthcare system that’s increasingly difficult to navigate, including growing concerns over the influence of vertically int

The House Education and Workforce Committee's Subcommittee on Health, Employment, Labor, and Pensions recently held a hearing on how pharmacy benefit managers are driving up prescription drug costs at the expense of American employers and patients. Members on both sides of the aisle condemned PBM practices as opaque, anti-competitive and costly. The primary legislative focus was Chairman Rick Allen's (R-GA) PBM Kickback Prohibition Act, which would prohibit PBMs from paying

What if insurer middlemen stood between you and a life-saving medication? This is the case for far too many Americans. Brandon was a 52-year-old accountant from Texas diagnosed with stage III colon cancer. He battled it into remission - until it came back at age 56. His community oncologist prescribed an oral chemotherapy designed for patients in his situation. His prescription was sent to a specialty pharmacy. That pharmacy couldn't fill it and passed it to a second. The sec

The House Committee on Ways & Means will hold a hearing on April 21 titled “ Protecting Patients & Taxpayers: Cracking down on Medicare Fraud .” Mark Blum, managing director of the PBM Accountability Project, issued the following statement: “The PBM Accountability Project welcomes the House Ways & Means Committee’s focus on identifying and addressing fraud in the Medicare program. As lawmakers examine vulnerabilities that drive unnecessary costs for taxpayers and beneficiari

This week, the Senate Health, Education, Labor & Pensions (HELP) Committee will hold a hearing titled, ” Making Medicines More Affordable: How Competition Can Lower Drug Prices .”Mark Blum, managing director of the PBM Accountability Project, issued the following statement:  “This latest hearing comes at a critical moment. What was once a marketplace built on consumer choice and fair negotiation has become increasingly dominated by vertically integrated insurance conglomerat

Ahead of the U.S. Department of Labor’s review of its proposed rule , Improving Transparency into Pharmacy Benefit Manager Fee Disclosure , the PBM Accountability Project led a coalition of national organizations in sending a letter to Secretary Lori Chavez-DeRemer applauding the Department’s leadership in advancing long-overdue, common-sense guardrails to rein in the unchecked influence of PBMs over employer-sponsored prescription drug benefits. “We have seen undeniable ev

Pharmacy benefit managers (PBMs) are once again resorting to misleading claims in a continued effort to deflect from the growing scrutiny their industry faces – from investigations and legal challenges to bipartisan calls for meaningful reform. This time, the PBMs’ national trade organization, PCMA, is mischaracterizing the conclusions of a recent report around commonly used asthma medication. PCMA is once again predictably misrepresenting the true drivers of inhaler list

PBM Accountability Project recently submitted a comment to the Federal Trade Commission strongly supporting its proposed Decision and Order against Express Scripts, Inc., Evernorth Health, Inc., Medco Health Services, Inc., and Ascent Health Services LLC . As a coalition of leaders and stakeholders across healthcare, labor, business, pharmacy, and patient and consumer advocacy, we view this enforcement action as a critical step toward restoring transparency, fairness and acco

This week, the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled, “ Protecting Patients and Safeguarding Taxpayer Dollars: The Role of CMS in Combatting Medicare and Medicaid Fraud .” Mark Blum, managing director of the PBM Accountability Project, issued the following statement: “The PBM Accountability Project welcomes the Committee’s focus on rooting out waste, fraud and abuse in Medicare and Medicaid and urges l

Insurer owned PBMs are no longer just middlemen; they are the architects of many of the drug pricing and access abuses patients and providers are fighting every day. Nearly 80% of all prescription claims run through three PBMs owned by CVS Health/Aetna, Cigna’s Evernorth and UnitedHealth Group, giving these conglomerates the power to design the benefit, control the pharmacy network and capture the spread between what is paid in and what is paid out. Behind familiar complain