SUPER MARKET NEWS: Lawmakers introduce comprehensive PBM reform bill

A bipartisan group of U.S. House leaders have introduced the Pharmacists Fight Back Act, which they describe as the most comprehensive effort to change the way pharmacy benefit managers operate.

The bill calls for pharmacy prescription reimbursements to be based on drug acquisition costs plus dispensing fees for drugs covered by federal payment plans, including Medicare, Medicaid and the Federal Employees Health Benefits Program. It also bans so-called "patient steering" that funnels patients into PBM-owned pharmacies, and it redirects a portion of PBM rebates to patients and plan sponsors. The bill is supported by the National Community Pharmacists Association and others.

The legislation was introduced last week by Reps. Jake Auchincloss (D-Mass.), James Comer (R-Ky.) and Diana Harshbarger (R-Tenn.).

"PBMs have abused their position as middlemen to line their own pockets by retaining rebates and fees, undermine our community pharmacists and pass along costs to patients at the pharmacy counter," said Comer. "This legislation takes meaningful steps to protect patients and our community pharmacists, ensuring they can access and provide affordable, life-saving medications to Americans without PBM interference."

Two versions of bill introduced

Two versions of the bill were introduced under their respective jurisdictions under the House Committee on Energy & Commerce and the House Oversight Committee . The bills' sponsors and other supporters held a press conference on Friday on Capitol Hill to promote passage of the legislation.

"The largest PBMs today exercise significant power over what drugs are available, at what price and what pharmacies that patients can use to access their prescribed medications-all with very little accountability or transparency," said Rep. Sanford Bishop (D-Ga.) at the press conference.

Other legislation had previously been introduced to curb PBM pricing practices, including the PBM Reform Act (H.R. 4317) and the PBM Price Transparency and Accountability Act (S. 3345). Both had been introduced earlier this year and have been referred to House committees.

"With this legislation and the other legislative proposals introduced in Congress, legislators have many options at their disposal to check the PBMs-and no reason to delay," said Douglas Hoey, CEO of NCPA. "PBM reform would rein in the big health insurance lobby, make prescription drugs more affordable for consumers and throw a lifeline to the thousands of small, family owned pharmacies that are on the brink of closure."

PBMs blamed for drug-price increases

Pharmacies have long blamed PBMs for squeezing their profit margins and driving up the cost of prescription drugs. The new legislation also comes as inflation and the cost of living have become a hot-button issue for legislators ahead of the 2026 mid-term elections.

The Pharmacists Fight Back Act seeks to create a more transparent pharmacy reimbursement model using market-based pricing benchmarked to the National Average Drug Acquisition Cost (NADAC). It also enforces stricter penalties and more stringent oversight of PBMs working with federal health plans, according to a statement issued by the bill's sponsors.

"These bills have teeth, and they include robust enforcement mechanisms to ensure that the PBMs comply," Bishop said at the press conference.