Energy and Commerce hearing spotlights pharmacy benefit managers' role in high drug costs and local pharmacy closures

Chairman Carter convened a House Energy and Commerce subcommittee hearing on pharmacy benefit managers (PBMs), where lawmakers and expert witnesses described PBM market concentration and opaque business practices as contributors to rising prescription costs and shrinking access to local pharmacies.

The hearing brought patient stories, state audit findings and federal reports into the record and featured testimony from independent pharmacists, employer-purchaser representatives, consumer advocates and health economists.

Why it matters: Witnesses and members said PBM practices—rebate-driven formularies, spread pricing, and vertical integration—can increase list prices, raise patient out-of-pocket costs, and steer business to PBM-affiliated pharmacies, which they said harms independent pharmacies and can reduce access to care, particularly in rural or underserved areas.

Hugh Chancey, a pharmacist and co-owner of Chancey Drugs, told the subcommittee that PBM practices have jeopardized his pharmacy’s ability to serve people in South Georgia. Chancey testified that “the top 3 PBMs control over 80% of the market,” and described instances in which PBMs steered patients away from community pharmacies and required mail-order fills that led to late or missed medications.

Sean Grimminger, president and CEO of the National Alliance…