A bipartisan group of lawmakers in both chambers of Congress has reintroduced a bill aimed at barring companies from owning both a pharmacy benefit manager and retail pharmacies.
The bill, called the Patients Before Monopolies (PBM) Act, would force conglomerates that include a PBM to divest pharmacies that they own. The legislation has existed in some form since 2024, and since its first introduction, Arkansas has implemented a similar legislation at the state level.
Last month, Tennessee legislators also passed a bill that would prevent PBMs from owning pharmacies, which the governor is expected to sign into law.
Rep. Diana Harshbarger, R-Tennessee, the bill’s lead sponsor, said in an announcement that as a pharmacist, she’s “seen firsthand how PBMs game the system.”
“When the same corporate giant that sets reimbursement rates also owns the pharmacy collecting them, that’s not a free market—it’s a rigged one,” Harshbarger said. “We have antitrust laws for a reason. When monopolies raise costs for patients, squeeze out independent pharmacies, and reduce consumer choice, Congress has a duty to restore fair competition.”
Harshbarger is co-sponsoring the bill alongside Rep. Jake Auchincloss, D-Massachusetts. On the Senate side, Sens. Elizabeth Warren, D-Massachusetts, and Josh Hawley, R-Missouri, are co-sponsors.
Other senators and representatives have signed on to support the bill, per the announcement.
“Our PBM Act is gaining momentum because people are realizing that you can’t lower healthcare costs without tackling corporate greed in the health care system,” Warren said in the announcement. “It’s time we finally rein in the health care middlemen that are jacking up drug costs and driving small pharmacies out of business.”
After years of debate, Congress passed substantial reforms for pharmacy benefit managers earlier this year as part of a bipartisan health funding deal. Under that law, PBMs must pass rebates, fees and other funds through to the payer, or be subject to fines from the Centers for Medicare & Medicaid Services.
The law also requires that PBM fees in Medicare Part D be “delinked” from drug pricing.
The reintroduced PBM Act secured a quick endorsement from the National Community Pharmacists Association, a loud critic of the pharmacy benefit management industry.
“PBMs have a choice—operate as a PBM or operate as a pharmacy, but you can’t have it both ways,” said NCPA CEO B. Douglas Hoey in a statement.
“The giant corporate PBMs are trying to use smoke and mirrors to convince members of Congress and state legislators that there’s nothing wrong with their business practices,” Hoey said. “But we know better.”
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