The Sconi

State Attorney General Joshua Kaul (D-Wisconsin) sent a letter to U.S. Congressional leadership this week saying Congress should “act to ensure fulsome regulation of pharmacy benefit managers (PBMs).

“The FTC and Congress must act to ensure fulsome regulation of PBMs nationwide,” said the letter. “Such legislation should reform PBM practices to curtail their ability to unreasonably raise the price of drugs and to require greater transparency.”

“Such transparency should, among other things, require PBMs to produce pricing data to health plans and federal and state regulators in a standardized format,” said the letter. “This will enable health plans to negotiate better deals with PBMs and will allow regulators to better hold PBMs accountable.”

A PBM is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. PBMs perform a variety of tasks such as processing and paying prescription drug claims, negotiating discounts and rebates with drug manufacturers, and managing pharmacy networks. 

The letter signed by Kaul was also signed by 47 different state attorneys general, and was sent to U.S. House Speaker Mike Johnson (R-La.), House Minority Leader Hakeem Jeffries (D-N.Y.), U.S. Senate Majority Leader Chuck Schumer (D-N.Y.), and Senate Minority Leader Mitch McConnell (R-Ky.)

Kaul's letter also said three pending bills in Congress, The DRUG Act (S1542/HR6283), Protecting Patients Against PBM Abuses Act (HR2880) and The Lower Costs, More Transparency Act (HR5378), “would be an important first step toward reforming” PBMs.