In Washington, Congress did not take any action this spring to regulate the operations of pharmacy benefit managers (PBMs), despite efforts by legislative bodies to address issues related to PBMs. The Pharmaceutical Care Management Association, the largest trade group for PBMs, significantly increased its lobbying spending by 71% from $2.8 million to $4.8 million in the first three months of the year.
Despite their influence, there were initiatives in Congress that aimed to increase transparency and reform how PBMs function in various sectors. The House passed a package focused on transparency while Senate committees passed reforms for PBMs in Medicaid, Medicare, and commercial insurance markets. Additionally, public health programs required funding in a government spending bill, allowing members of Congress to avoid voting on individual issues.
The position of PBMs as intermediaries between drugmakers and health insurers faced challenges during negotiations due to increasing scrutiny and potential reforms. Despite these challenges, industry lobbyists worked hard to maintain the status quo and prevent significant changes to how PBMs operate. As a result, Congress failed to take any action on regulating the operations of PBMs, leaving the industry free from additional regulations.