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Senators, experts press PBM reforms and ‘delinking’ proposals to lower drug costs
Summary
Witnesses and senators at the HELP hearing urged transparency and structural reforms for pharmacy benefit managers, including proposals to delink PBM compensation from list prices, retrospective merger review and stronger fiduciary rules for plan sponsors.
At a Senate HELP Committee hearing on health‑care affordability, lawmakers and witnesses focused on pharmacy benefit managers (PBMs), arguing that opaque rebate and fee arrangements raise drug prices and that structural reforms are needed so employers and patients benefit from negotiated discounts.
Why it matters: PBMs mediate most prescription drug purchases for insurers and employers; testimony at the hearing said employers and plan sponsors lack sufficient information to evaluate PBM contracts and that dominant PBMs contribute to consolidation that can raise costs.
Witnesses described how PBM practices can obscure true transaction prices…
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