House Committee Holds Final Hearing in Series on the Role of PBMs

The House Committee on Oversight and Accountability held a final hearing on the value of PBMs in the marketplace, with Adam Kautzner, PharmD, President of Evernorth Care Management and Express Scripts, testifying alongside executives from CVS Caremark and OptumRx. The Committee made it a priority to study PBMs when Republicans gained control of the House in 2022 after Democrats used the Committee to investigate pharmaceutical manufacturers over 2020-2021. Kautzner stood out as giving some of the most robust, substantive answers throughout the hearing – effectively combatting tough questioning lines with facts on several occasions, including when members raised the unsubstantiated conclusions in the Federal Trade Commission (FTC) interim report on PBMs. However, there remain challenging themes the industry needs to effectively address – contracting practices with pharmacies, which were deemed unfair, the creation and value of group purchasing organizations, and the impact of prior authorization and step therapy measures on patients. Adam Kautzner’s written testimony can be found here.

Immediately prior to the hearing, Committee Republicans released a report after demanding thousands of documents from Express Scripts, CVS Caremark, and OptumRx over 2023-2024. Similar to the FTC’s report, the Oversight report only highlighted statements from the documents collected to serve the intended political narrative and presented unsubstantiated conclusions, which are not reflective of the materials Express Scripts provided. As noted below, a third-party analysis of all data submitted to the FTC was released by economist Dennis W. Carlton, Ph.D., that provides additional proof of the value of PBMs in encouraging greater competition in the supply chain and lowering costs for plan sponsors and patients.