119th Congress Continues Momentum on PBM Reform

April 9, 2025

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Both chambers of Congress are pressing forward with PBM reform efforts, reintroducing several bills that stalled in the last session. Sens. Chuck Grassley (R-IA) and Maria Cantwell (D-WA) reintroduced their bipartisan proposals to address transparency and drug pricing concerns: the Prescription Pricing for the People Act would require a federal study of industry consolidation and pricing practices, while the Pharmacy Benefit Manager Transparency Actwould ban claw backs of payments made to pharmacies and expand the Federal Trade Commission’s authority to regulate PBM business practices.

Separately, Sen. Dick Durbin (D-IL) reintroduced the Drug-price Transparency for Consumers (DTC) Act, which would require disclosure of prescription drug costs in direct-to-consumer advertising. In the House, lawmakers have revived measures like the Saving Seniors on Prescriptions Act, which would implement reporting requirements for PBMs under Medicare Part D and Medicare Advantage.

While more popular legislative proposals – including the Lower Costs, More Transparency Act – have yet to be resurrected, these early reintroductions are indicative of bipartisan support to move forward with PBM reforms this year.

Initiatives

Calls grow for Drug Patent reform

In a recent blog post, the Pharmaceutical Care Management Association (PCMA) highlighted increased attention to pharmaceutical companies’ abuse of drug patents. Last month, the Supreme Court unanimously ruled in favor of a generic drugmaker in a “skinny labeling” case, a victory for patients. Skinny labels allow generic and biosimilar competitors to launch products for non-patented indications, helping accelerate […]
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August 11, 2026

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perspectives

AHIP calls for Bipartisan reform to address health care cost drivers

On July 23, AHIP President and CEO Mike Tuffin wrote an opinion piece in The New York Times saying, “common-sense bipartisan reforms are needed to promote competition in care delivery and prescription drugs, protect consumers from providers and drugmakers’ anticompetitive practices and transition away from the perverse incentives of fee-for-service medicine.” Tuffin notes that health […]
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August 11, 2026

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Solutions

PCMA urges preserving patient access and flexibility in new fertility benefits rule

PCMA recently submitted comments to HHS, DOL, and the Treasury (the Departments) in response to the proposed rule establishing a new category of limited excepted benefits for fertility services. PCMA supports the Departments’ goal of expanding access to fertility care while encouraging employer innovation but urged several targeted refinements to ensure the framework is operationally […]
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August 11, 2026

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