PBM Lobbying Efforts Fail to Stop Congress from Taking Action on Regulations

In Washington, Congress did not take any action this spring to regulate the operations of pharmacy benefit managers (PBMs), despite the efforts of lobbyists in the industry. 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 the efforts made by PBMs to influence the outcome, 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. With increasing scrutiny and potential reforms, industry lobbyists worked tirelessly to maintain the status quo and prevent any significant changes to how PBMs operate. Despite these efforts, legislative bodies continued to address issues related to PBMs, but ultimately lacked action by Congress allowed the industry to continue operating without additional regulations.