PCMA Highlights Recent Pro PBM Comments

September 9, 2025

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PCMA recently highlighted several op-eds from policy analysts and economists who have spoken out on the value of PBMs. Satya Marar, visiting postgraduate fellow at the Mercatus Center at George Mason University, explained in a CounterPunch op-ed why PBMs are necessary to push back against the high list prices that drug companies alone set: “We’d pay even more if private health plans didn’t pool patients together and collectively bargain on drug prices through intermediary PBMs.”

A recent op-ed in Inside Sources by policy analyst Jason Reed echoes Marar’s assessment: “PBMs are the little-known heroes of the American health care system. They act as intermediaries to negotiate drug prices with Big Pharma on behalf of consumers…keeping Big Pharma in check and maximizing healthcare accessibility in exchange for meager profit margins as low as 2 percent (well below the S&P 500 average of 12 percent).”

Dr. Jeremy Nighohossian, senior fellow and economist at the Competitive Enterprise Institute, argues in a blog post that PBMs “play an integral role in negotiation and sourcing behind the scenes” and warns lawmakers in Washington against interfering with the PBM market that is delivering lower drug costs for Americans.

In an Inside Sources op-ed, Marar similarly cautions against pursuing policies that would undermine the ability of PBMs to negotiate lower drug prices: “Blanket, industrywide restrictions on negotiation practices that benefit patients and health plans would serve vested interests while backfiring on those they’re meant to help.”

legislation

Virginia and Hawaii Introduce PDAB Legislation

The Virginia Senate introduced a bill to establish a Prescription Drug Affordability Board (PDAB) to review drugs with a wholesale acquisition cost (WAC) of $60,000 or more per year or a WAC increase of $3,000 or more in any 12-month period. For drugs deemed to cause an affordability challenge, the legislation authorizes the PDAB to […]
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February 12, 2026

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Solutions

AHIP Shares Update on Plan Progress to Simplify Prior Authorization

AHIP shared progress on the voluntary, multi-year commitments made by AHIP, BCBSA, and leading health plans (including Cigna Healthcare) to streamline and simplify prior authorization. Health plans serving nearly 270 million Americans are participating in this initiative. The 2026 commitments took effect on Jan. 1 and include: reducing the scope of claims subject to prior […]
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February 12, 2026

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legislation

DOL Issues Proposed Rule on Improving Transparency into PBM Fees

Pursuant to President Trump’s Executive Order “Lowering Drug Prices by Once Again Putting Americans First,” the Department of Labor’s (DOL’s) Employee Benefits Security Administration (EBSA) issued a proposed rule that would require providers of PBM services and affiliated entities of brokerage and consulting services to disclose direct and indirect compensation to their self-funded ERISA fiduciary […]
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February 12, 2026

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