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Medicare Drug Price Negotiations: Without Real PBM Reform, Middlemen Keep Rx Savings and Patients Pay the Price
By Mark Blum, Managing Director, PBM Accountability Project The Centers for Medicare & Medicaid Services (CMS) recently released results of a second round of CMS-negotiated Maximum Fair Prices for selected drugs under the Inflation Reduction Act (IRA). This transparency from the agency is promising as it allows policymakers and the public to better understand how negotiated prices may influence both patient out-of-pocket costs and federal spending. Taking a Closer Look
Dec 5, 2025
Congress Must Act: Senate Hearing Highlights Urgent Need for PBM Reform
In recognition of a universal desire to increase health care affordability, the Senate Finance Committee recently held a hearing titled “ The Rising Cost of Health Care: Considering Meaningful Solutions for All Americans ” to examine possible policy solutions. PBM reform remains the most practical, bipartisan proposal to lower costs, as committee Chairman Mike Crapo (R-ID) highlighted in his opening remarks . Senator Mike Crapo (R - ID) mentioned PBM reform as a main is
Nov 25, 2025
The PBM Accountability Project Calls on Congress for Immediate PBM Reform
The PBM Accountability Project Managing Director Mark Blum submitted a letter to Congressional leaders today urging them to take action to make health care more affordable for American patients by passing meaningful PBM reform legislation. The committee began working on legislation to rein in these middlemen in 2024 and must not miss an opportunity to advance legislation that prohibits the anti-patient, anti-competitive practices that have allowed PBMs to profit at the expens
Nov 19, 2025
Independent Pharmacies Under Pressure: The Impact of PBMs and Vertical Integration
Independent pharmacies play a significant role in delivering prescription medicines to Americans across the country, representing 35% of all retail pharmacies in the U.S. In recent years, there has been an alarming and continuing rate of independent pharmacy closures - nea rly one in three pharmacies have closed since 2010, leaving almost 800 ZIP codes that had at least one pharmacy in 2015 now having none. A primary factor behind the decline of independent pharmacies
Nov 8, 2025
Don’t Fall for the Cigna Head Fake
By Mark Blum, Managing Director, PBM Accountability Project The insurance carrier Cigna’s Evernorth division issued a recent announcement that its pharmacy benefit manager ( PBM) Express Scripts will stop collecting manufacturer rebates in 2028. The announcement was the PBM equivalent of a head fake in football, an all-too-common deflection tactic well-known to those who have tracked the PBM industry since inception. The insurance company that owns Express Scripts wants poli
Nov 8, 2025
California Passes Critical PBM Reforms
California’s SB 41 is a major win for PBM accountability, passing the legislature with broad bipartisan support and earning Governor Newsom’s signature this month. This legislation is one of the strongest protections to date against anti-consumer PBM practices and includes important provisions to: require PBMs in California to be licensed and subject to oversight, ending their near-total lack of regulation in the state ban spread pricing – the practice where PBMs charge ins
Oct 14, 2025
PBM Accountability Project Statement on PBM Lobbying Efforts to Avert Accountability
The PBM industry’s lobbying arm is reportedly working to avoid new federal regulations, suggesting instead that PBMs police themselves....
Sep 26, 2025
CBO Report Reveals Massive Abuse of 340B Program by Hospitals and PBMs
As Congress prepares for the final legislative push of 2025, a new report from the Congressional Budget Office (CBO) reinforces the need...
Sep 17, 2025
The PBM Accountability Project Calls on Congress for Immediate PBM Reform This Fall
The PBM Accountability Project Managing Director Mark Blum today submitted a letter to Congressional leaders urging swift action to pass...
Sep 10, 2025
PBM Accountability Project Calls on FTC and DOJ for Urgent PBM Reform Following Drug Pricing Listening Sessions
The PBM Accountability Project Managing Director Mark Blum submitted a letter to the Federal Trade Commission (FTC) and Department of...
Sep 5, 2025
PBM Accountability Project Statement on Chairman Comer’s Expanded Investigation into PBM Practices
The House Committee on Oversight and Government Reform Chairman James Comer (R-KY) recently announced an expanding investigation into...
Sep 4, 2025
PBM Reform Should be at the Top of Congress' Fall Agenda
As Congress returns this fall, there are likely several items on their “To Do” list – addressing healthcare costs should be near the very...
Aug 28, 2025
PBM Accountability Project Statement on Senate HELP Committee Hearing on Healthcare Affordability
The Senate HELP Committee today held a hearing entitled, “Making Health Care Affordable: Solutions to Lower Costs and Empower Patients.”...
Aug 1, 2025
PBM Accountability Project Encourages Senate HELP to Consider PBM Reforms to Lower Drug Costs
The PBM Accountability Project today sent a letter to Senate HELP Committee leaders supporting ongoing efforts to make healthcare more...
Jul 31, 2025
PBM Accountability Project Applauds Introduction of the PBM Reform Act (H.R. 4317)
The PBM Accountability Project, representing a wide range of stakeholders across the business, labor, patient, consumer and pharmacy...
Jul 16, 2025
PBM Accountability Project Statement on The PBM Reform Act
Representative Buddy Carter (R-GA), along with 11 bipartisan members of Congress, today introduced the PBM Reform Act to reform the...
Jul 10, 2025
PBM Accountability Project Urges Congressional Leaders to Prioritize PBM Reforms in Budget Reconciliation
The PBM Accountability Project Managing Director Mark Blum today sent a letter to Congressional leadership calling for the inclusion of...
Jun 23, 2025
Expanding the 340B Program Allows PBMs to Steal from Patients in Need
Hospitals and clinics in the 340B program often use pharmacy benefit manager (PBM) affiliated or owned contract pharmacies to dispense...
Jun 12, 2025
New Poll: Overwhelming Majority of Nevadans Support Regulation of Prescription Drug Middlemen
Respondents support policies to require pharmacy benefit managers (PBM)s to provide value, lower patient drug costs Carson City, NV – As...
May 23, 2025
We Can Wait No Longer: Congress Needs to Aid Those Trapped in a Health Care Nightmare
By: Claire Sachs, Founder of the Patient Advocate’s Chronicle and a DPAC Champion Corps member Millions of Americans afflicted with...
May 19, 2025
PBM Accountability Project Statement on House Energy and Commerce Committee Budget Reconciliation Text
WASHINGTON, DC – During a full committee markup , the House Energy and Commerce Committee advanced budget reconciliation language...
May 15, 2025
Senate Judiciary Committee Members Urge PBM Reform
The Senate Judiciary Committee held a hearing this week titled, “PBM Power Play: Examining Competition Issues in the Prescription Drug...
May 15, 2025
PBM Accountability Project Statement on Trump Administration Efforts to Address High Prescription Drug Costs
President Trump this week signed an executive order that revived a drug pricing policy, known as the “most favored nation” policy, that...
May 14, 2025
New Report: PBMs Are Siphoning Money from Patients in the 340B Program
A recent report found that the dominance of pharmacy benefit managers (PBMs) in the 340B drug pricing program benefits these large...
May 12, 2025
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