Don't miss this! This week there is a hearing at the Subcommittee on Health titled An Examination of How Reining in PBMs Will Drive Competition and Lower Costs for Patients.
Optum RX, CVS Caremark, & Express Scripts are pharmacy benefit managers or PBMs. All three have merged with insurance companies. A recent study by the Federal Trade Commission (FTC) shows that the PBMs have price gouged patients, taxpayers, and employers as they force to their own mail order pharmacies by charging up to 1000% more on the costs of medications than an average price.
At a government hearing last year, the PBMs lied under oath stating that they do not steer patients to their own mail order pharmacy. Will they tell more lies? Will they ever be held accountable? For any of us who have received the letters of "must use mail order" or "have a higher copay" or in our case, "pay 100% of the cost" it would be a laughable joke if the lies wouldn't be creating so much harm to patients and communities who now live in pharmacy deserts due to the monopolization of the industry. All the entities in the system, including taxpayers, who are getting overcharged. The same companies also oversee competitor reimbursements and per the FTC's study, the PBMs almost always paid their own pharmacies more than competitors.
The witnesses have not been announced yet. Will the CEOs or executives show? To be determined. For once, can our government just function well enough to finally hold these PBMs and their insurance companies accountable and create real change through legislation? America needs to see accountability.
Hearing Information:
WHAT: Subcommittee on Health hearing to examine PBM reform policies.
DATE: Wednesday, February 26, 2025
TIME: 10:00 AM ET
LOCATION: 2123 Rayburn House Office Building
This notice is at the direction of the Chairmen. The hearing will be open to the public and press and will be live streamed online at energycommerce.house.gov.
I'll be on the edge of my seat watching with you!
Thank you,
Loretta Boesing, Patient Advocate