Pharmacy benefit manager reform fails to make the cut in federal funding package

For a moment, it looked like Congress would actually enact reforms of controversial pharmacy benefit managers after several years of introducing bills and holding hearings.

For a moment, it looked like Congress would actually enact reforms of controversial pharmacy benefit managers after several years of introducing bills and holding hearings. But it was not to be. The slate of measures that would have injected more transparency into the industry and changed some of its practices were stripped from the massive bipartisan government funding package that was torpedoed by President-elect Donald Trump and billionaire Elon Musk on Wednesday. The final, vastly slimmed-down legislation, which prevented the federal government from shuttering, was signed by President Joe Biden on Saturday. However, the efforts to overhaul the PBM industry will likely continue next year. Trump blasted the industry at a recent news conference at Mar-a-Lago, after saying that Americans pay too much for drugs. “We have a thing called the middleman. You know the middleman, right?” Trump said at his Florida estate. “The horrible middleman that makes more money frankly than the drug companies, and they don’t do anything except they’re a middleman. We’re going to knock out the middleman.” Pharmacy benefit managers serve as middlemen between drug manufacturers and insurers, employers and governments. They negotiate rebates from pharmaceutical companies, determine which medications are covered by insurance plans and pay pharmacies. But they have raised the ire of Congress and others with their opaque practices.