House oversight panel blames PBMs for higher prices

Drug benefits middlemen engage in anticompetitive practices to push patients toward higher-cost medicines and boost their profits, according to a Congressional report released Tuesday.

The House Committee on Oversight and Accountability posted its findings ahead of a hearing with leaders of the three largest pharmacy benefits managers, units of CVS Health Corp., Cigna Group and UnitedHealth Group Inc. Despite PBMs’ assertions that they lower medication costs, the House panel reached the opposite conclusion.

“Patients are seeing significantly higher costs with fewer choices and worse care,” the report said. 

The findings add to pressure on the industry that’s facing scrutiny and possible legal action from antitrust regulators over the high and rising prices of drugs in the US. With one in five Americans not filling a prescription because of cost, according to a KFF poll, drug middlemen are coming under fire for their role in setting those prices.

The industry has pushed back against the criticism, saying PBMs lower overall drug costs and blaming pharmaceutical companies for the sticker shock. Ahead of the hearing, a public affairs firm circulated an analysis jointly sponsored by the three largest PBMs that said data doesn’t support the idea that they drive prices higher.

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