Senators Marshall & Blunt Rochester Introduce Legislation to Help Lower Prescription Drug Costs Through PBM Transparency

Washington - On Thursday, U.S. Senator Roger Marshall, M.D. (R-Kansas) and Senator Lisa Blunt Rochester (D-Delaware), introduced the PBM Disclosure Act, bipartisanlegislation that would require Pharmacy Benefit Managers (PBMs) and other third-party administrators to disclose all forms of direct and indirect compensation they receive while managing prescription drug benefits for employer-sponsored health plans.

"Americans deserve a fair deal, not a rigged system where PBMs profit while families struggle to afford their medications,"said Senator Marshall. "This bill is a straightforward transparency measure that will help employers understand what they're paying for and help stop PBMs from gaming the system."

"With health care costs sky high, the last thing families and employers should have to deal with is confusion and opacity in the system. I'm grateful to build upon my work in the House to reform our PBM system alongside Senator Marshall. This bill is a commonsense, bipartisan step toward transparency and accountability within our health care system." said Senator Rochester.

Background:

• PBMs are third-party companies that administer prescription drug benefits on behalf of health insurance plans.
• They use various predatory practices such as formulary prices, rebates, spread pricing, and others to increase their profits at the cost of patients.
• These middlemen are also vertically integrated and use their positions to prevent competition and drive up prices.
• Congress has worked on several proposals to stop PBMs and lower prescription drug prices, and Senator Marshall has been a cosponsor of many of these efforts.

The PBM Disclosure Act would:

• Require PBMs and third-party administrators to disclose all direct and indirect compensation they receive, ensuring employers and plan sponsors have full visibility into the true cost of pharmacy benefit services.
• Increase transparency to prevent predatory or deceptive PBM practices, which currently contribute to unclear pricing and higher drug costs.
• Help lower the cost of prescription drugs by exposing hidden payments and ensuring market decisions are based on value rather than behind-the-scenes financial incentives.

Full text of the bill is available here.

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