Aderholt, Comer Continue PBM Investigation, Urge CMS to Protect Patient Care Under New Bipartisan Reforms

WASHINGTON- Congressman Robert Aderholt (R-Ala.) and House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) are continuing their investigation into pharmacy benefit managers (PBMs) and are urging the Centers for Medicare & Medicaid Services (CMS) to protect patient care as new bipartisan reforms are implemented.

Aderholt also pointed to the real-world impact of PBM practices on independent pharmacies in North Alabama, including a column by Brooke Walker, a pharmacist at Geraldine Drugs in DeKalb County, who described the growing financial strain these practices are placing on community pharmacies and their customers.

"In her heartfelt piece, Brooke Walker made clear what I've been hearing across our district, independent pharmacists are being pushed to the brink by unfair reimbursement practices," said Congressman Aderholt. "These pharmacies are more than businesses; they are lifelines for our rural communities."

PBMs act as middlemen in the prescription drug supply chain, determining reimbursement rates and influencing where patients fill prescriptions. Critics say their practices-including low reimbursement rates and steering patients toward affiliated pharmacies-have contributed to the closure of independent pharmacies across Alabama and the country.

In Alabama alone, pharmacists have warned that they are sometimes paid less than the cost of filling prescriptions, with some reporting losses on a significant share of medications. These pressures have led to widespread pharmacy closures, particularly in rural communities where access to care is already limited.

"Patients in places like rural Alabama shouldn't have to drive miles to fill a prescription because their hometown pharmacy was forced to close," Aderholt continued. "That's why this issue matters-not just in Washington, but in communities across our district."

In a letter to CMS, Aderholt and Comer emphasized that recently passed bipartisan reforms aimed at increasing PBM transparency and accountability must be implemented in a way that:

• protects patient access to medications,
• ensures fair reimbursement for pharmacies, and
• prevents PBMs from circumventing the law.

"The House Oversight Committee exposed how the three largest PBMs colluded to line their own pockets," said Chairman Comer. "These self-benefitting pricing tactics have done nothing but jeopardize patient care, undermine local pharmacies, and raise prescription drug prices. Congress took action to advance legislative solutions to support patients and provide greater transparency in the PBM industry. While these new bipartisan reforms take effect, CMS must also ensure patients are protected and can access quality care without interference from PBMs. Americans deserve affordable medications, and Congress will continue to work in a bipartisan fashion to restore competition in the pharmaceutical marketplace."

"Congress has taken important steps to rein in PBMs," Aderholt said. "Now CMS must ensure these reforms are carried out as intended so patients-not middlemen-come first."

The lawmakers pledged to continue their oversight efforts to ensure that federal policy strengthens patient protections, lowers prescription drug costs, and preserves access to care in communities like those across North Alabama.

###