12/18/2024

Patients Before Monopolies Act to End Conflicts of Interest Between Pharmacies, PBMs

In a bipartisan move to continue the scrutiny of pharmacy benefit managers (PBMs) in Congress, Senators Elizabeth Warren (D, Massachusetts) and Josh Hawley (R, Missouri) introduced legislation that would prohibit corporations’ collective ownership of both PBMs and pharmacies. According to a news release, the aptly named “Patients Before Monopolies” Act was designed to limit the conflicts of interest that are negatively impacting patients and independent pharmacies alike.¹

“PBMs have manipulated the market to enrich themselves—hiking up drug costs, cheating employers, and driving small pharmacies out of business. My new bipartisan bill will untangle these conflicts of interest by reining in these middlemen,” said Senator Warren.

Introduction of the Patients Before Monopolies Act comes at a time of great disapproval towards PBMs for a myriad of unfavorable business practices. Indeed, in the 118th Congress alone, this legislation joins 3 other PBM-related bills intended to thwart their noticeable control of the market. The other 3 notable bills include the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 (S.3430); Modernizing and Ensuring PBM Accountability Act (S.2973); and Pharmacy Benefit Manager Transparency Act of 2023 (S.127).

While previously introduced bills focused on specific PBM tactics, such as spread-pricing or opaque contracting, the Patients Before Monopolies Act is attempting to go after the larger corporations that control PBMs and pharmacies together. Aiming to totally separate PBMs from big-chain pharmacies, the Patients Before Monopolies Act has major implications for some of the largest health care conglomerates in the US.

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