Comer Investigates PBMs for Retaliatory Audits of Independent Pharmacies

Seeks documents, communications, and briefings from CVS Caremark, Express Scripts, and Optum Rx

WASHINGTON-House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) is investigating whether pharmacy benefit managers (PBMs) targeted independent pharmacies with punitive audits in retaliation for publicly supporting bipartisan legislation to rein in predatory PBM tactics. In letters to CVS Caremark, Express Scripts, and Optum Rx, Chairman Comer raises concerns that independent pharmacies experienced an unusual surge in burdensome audits after supporting H.R. 6610, the Pharmacists Fight Back in FEHB Plans Act. Chairman Comer is now requesting documents, communications, and staff-level briefings about the PBMs' audit practices, pharmacy selection processes, and nationwide audit totals, as well as detailed records concerning audits of independent pharmacies in Kentucky, Mississippi, and Florida.

"The Committee is concerned that independent pharmacies have potentially been targeted for punitive audits in retaliation for their public support of legislation recently passed by the Committee. In the short span of time since the Committee's July markup of H.R. 6610, the Pharmacists Fight Back in FEHB Plans Act, multiple independent pharmacies that supported the Committee's efforts have received an unusual number of burdensome audit notices in short succession from several PBMs. This raises concern that these audit notices were sent or timed to retaliate for their support of H.R. 6610," wrote Chairman Comer.

One audit was related to a medication with a cost of $0.99 that resulted in hundreds of hours of staff time for the independent pharmacy. Since 2021, Chairman Comer has investigated harmful PBM practices and worked to make life-saving prescription drugs more affordable by reforming the PBM payment system. Instead of prioritizing the health of Americans across the country, evidence released in a House Oversight Committee report shows how the three largest PBMs have monopolized the pharmaceutical marketplace by deploying deliberate, anticompetitive pricing tactics that are raising prescription drug prices and undermining community pharmacies. The report concluded that the present role of PBMs in prescription drug markets is failing and requires Congress to implement legislative reforms to increase the transparency of the PBM market.

"Independent pharmacies play a critical role in communities across America and have every right to speak out in support of reforms without fear of retaliation. PBMs must not be allowed to weaponize the audit process to punish pharmacies that support greater transparency, lower prescription drug costs, and stronger protections for patients. The Committee will follow the facts and determine whether these audits were legitimate or were used to intimidate independent pharmacists," concluded Chairman Comer

Read the letters here: