Senators Elizabeth Warren and Josh Hawley and Representatives Diana Harshbarger and Jake Auchincloss introduced the Patients Before Monopolies Act on Wednesday. It aims to prohibit the parent company of a PBM or insurer from owning a pharmacy business.
U.S. senators and representatives introduced a bill on Wednesday that aims to prohibit the combined ownership of pharmacy benefit managers (PBMs) and pharmacies and require parent companies of PBMs to divest their pharmacy businesses.
The bill is called the Patients Before Monopolies Act (PBM Act) and was introduced by Senators Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.) with Representatives Diana Harshbarger (R-Tenn.) and Jake Auchincloss (D-Mass.).
It comes as PBMs — particularly CVS Caremark, Cigna’s Express Scripts and UnitedHealth Group’s Optum Rx — face scrutiny from the Federal Trade Commission due to being vertically integrated with large healthcare conglomerates. The FTC argues that PBMs have major power over which prescription drugs are available and at what price, and sometimes steer patients to their affiliated pharmacies over independent pharmacies.
To prevent this, the bill would:
- Prohibit the parent company of a PBM or insurer from owning a pharmacy business - Mandate that a parent company violating the PBM Act must divest its pharmacy business within three years - Allow the FTC, Department of Health and Human Services, DOJ’s Antitrust Division and state attorneys general to order violators of the act to divest their pharmacy business and return any revenue earned during the violation period - Direct the FTC to allocate disgorged funds to affected communities, including consumers overcharged at vertically integrated pharmacies
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