National Survey Shows a Vast Majority of Americans Want Comprehensive Reform of the 340B Drug Pricing Program

Media Contact: Lisa McDonald, Vice President of Communications, 202-207-2829  

National Poll Demonstrates Strong Support for Policies That Ensure Qualifying Patients Benefit Directly From 340B Drug Discounts, Hold 340B Hospitals & Covered Entities Accountable

Washington, DC Today, the National Consumers League (NCL) released results from a new Morning Consult national poll of more than 20,000 American adults, revealing overwhelming concern about the burden of medical debt and strong public demand for comprehensive reforms of the 340B Drug Pricing Program. Nearly four in five surveyed adults (78%) support establishing requirements to ensure that qualifying patients directly benefit from 340B drug discounts through reduced out-of-pocket prescription drug costs. More than three in four surveyed adults (77%) believe hospitals should be required to pass 340B savings directly onto patients.

The national poll also found that:

  • 54% of surveyed adults currently have or previously had medical debt, with those in rural areas and the South disproportionately affected. Among adults who have experienced medical debt, more than half (54%) reported skipping additional needed medical care due to cost.
  • Three in four surveyed adults (76%) expressed concern that hospitals benefiting from 340B drug discounts often pursue aggressive debt collection practices against patients.
  • A majority of polled adults strongly supported proposed reforms of the 340B program, including policies to ensure qualifying patients benefit directly from 340B through reduced out-of-pocket costs, allow audits on how hospitals and pharmacies are using the 340B program, and add a requirement that 340B hospitals share a portion of the savings they generate with qualifying 340B patients.

“The 340B program is supposed to help vulnerable patients access and afford life-saving medicines and care, but the evidence shows some hospitals, the pharmacies they contract with, and middlemen are abusing 340B for profit at the expense of low-income and uninsured patients,” said National Consumers League (NCL) CEO Sally Greenberg, JD. “Americans have said loud and clear: They want a 340B program that puts patients first, not profits. Congress must act now to institute comprehensive reforms that restore integrity and accountability to 340B before more patients are left behind.”

The 340B Drug Pricing Program allows hospitals and other covered healthcare entities to access medications at discounted prices from manufacturers with the intent that they pass savings onto patients. However, over time, some hospitals, the pharmacies they contract with, and pharmacy benefit managers (PBMs) have manipulated the program into a major profit-generating enterprise. In many cases, 340B hospitals charge patients full price for discounted drugs, keep the difference as profit, provide minimal levels of charity care, and pursue aggressive debt collection practices against the very patients the program was meant to protect.

This April, Senator Bill Cassidy, M.D. (R-LA), the Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a report detailing finds from a multi-year investigation of how covered entities abuse the 340B program. In the report, Sen. Cassidy outlined reforms meant to bring greater transparency to the 340B program, including requiring annual reporting on how 340B revenue is used to ensure direct savings for patients and providing clear guidelines to ensure that drug discounts actually benefit 340B-eligible patients.

By the Numbers: 340B Program Abuses Harm American Patients

  • Massive Price Markups. Medicine price markups are 6.6 times higher at 340B hospitals than at independent clinics, and research shows participation in 340B does not improve health outcomes for uninsured and low-income patients.
  • Declining Charity Care. 340B has grown exponentially to become the second largest federal prescription drug program after Medicare Part D. However, only $1 is invested in charity care for every $10 in profit collected by profitable 340B hospitals.
  • Lack of Transparency. Discounted purchases under 340B totaled a massive $66.3 billion in 2023. However, hospitals are not required to disclose their 340B profits or even whether their revenue is used to lower patient costs.

To learn more about the 340B Drug Pricing Program and the need for federal reforms of the program, visit: https://nclnet.org/340b-program/.

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About the National Consumers League (NCL)       

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.   

NCL signs on to PBM Accountability Project letter advocating for transparency and cost savings in prescription drug pricing  

Media Contact: Lisa McDonald, Vice President of Communications, 202-207-2829 

Washington, DC – The National Consumers League (NCL) is proud to announce its support for the PBM Accountability Project’s letter, which has been shared with the U.S. House Energy & Commerce Health Subcommittee ahead of their hearing on February 26, 2025. The PBM Accountability Project calls for urgent reform of the Pharmacy Benefit Manager (PBM) industry to increase transparency, reduce prescription drug costs, and provide relief to consumers and patients across the nation.    

The National Consumers League has growing concerns about the anti-competitive, anti-consumer, and anti-patient practices of the largest PBMs, which have created an opaque system that inflates prescription drug prices. NCL stands firm with the signatories in urging the subcommittee to advance bipartisan legislation that addresses these harmful practices and restores fairness to the prescription drug marketplace.     

“Consumers deserve transparency and affordability in healthcare,” said NCL CEO Sally Greenberg. “PBMs have been driving up costs for everyday Americans and their families, often without consumers realizing the true price of their medications. NCL’s commitment to consumer protection means advocating for policies that rein in the practices of these middlemen and prioritize patients over corporate profits. We must act now to bring down drug prices and ensure every American has access to affordable medications.”   

Consumers need immediate action to curb the influence of PBMs, whose practices have been detrimental to both patients and community pharmacies. Key bipartisan reforms highlighted in the letter include measures such as delinking drug prices from PBM revenues, implementing fair pharmacy contract terms, and ensuring rebates are passed directly to patients. These reforms are essential to lowering drug costs and increasing access to vital medications.   

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About the National Consumers League (NCL)    

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org. 

Charting Our Future: Evolving Frontiers of Engagement

For 125 years, America’s longest-standing consumer advocacy organization has made certain that the perspectives of consumers and workers play an important role in shaping government policies and business practices. The mission that began in 1899 continues today, but it involves taking on new and emerging challenges in a rapidly changing world.

A VIGILANT FOE AGAINST FRAUD 

Fraudsters get more clever every day. They take advantage of emerging technologies. They master new ways to use social engineering to exploit their victims. There are entire camps in other countries populated by victims of illegal trafficking who are kept against their will and forced to engage in activities to defraud Americans.

For every step they take, however, the National Consumers League is there to combat their scams and protect vulnerable consumers.

In 2024, scammers posing as law enforcement pressured
consumers to convert money into gold bars and hand
them over for ‘safe keeping’

NCL’s fight against fraud has three components. The first component is consumer education, utilizing interviews with media outlets, podcasts, and the organization’s Fraud.org website, to help people become more aware of the multiple ways in which scammers operate.

The second component is the far-reaching network NCL has built with law enforcement and partners in consumer-focused agencies. In 1992, NCL launched the National Fraud Information Center, which is Fraud.org. This website welcomes 100,000 unique visitors a year and has collected thousands of consumer complaints that are shared with a network of more than 200 law enforcement partners. Through its consumer education efforts and direct counseling support, Fraud. org has helped millions of consumers protect themselves and their loved ones against treacherous scams.

The third component is policy advocacy, because it is impossible for all consumers to keep up with the plethora of fraudulent activities. NCL has cracked down on the financial system’s more insecure payment methods, making it more difficult for bad actors to take advantage of them. NCL is expanding these efforts to focus on fraud related to gift cards, peer-to-peer payment apps, and cryptocurrency exchanges, to shut off criminal enterprises.

NCL’s anti-fraud work is victim-focused. For too long, fraud victims have been stigmatized, with blame placed on them instead of the criminals. For decades, victims felt they were at fault for being scammed. NCL has made it a priority to change the way the media and policymakers speak about fraud, making it clear that this is a crime and that we should not blame the victims who need to be supported.

NCL has been a powerful voice for airline passengers and safety

ADVOCATING FOR ACCESSIBLE, AFFORDABLE HEALTHCARE 

Healthcare in the United States is incredibly complex with many moving parts. For NCL, it boils down to a simple and essential principle —every person should have access to affordable, high-quality care.

Today, consumers and patients can face a bewildering array of barriers standing between them and the care they need. NCL has been their ally, testifying frequently against unreasonable policies like care-delaying prior authorization, step therapy practices that force patients to fail with insurer-preferred treatments before they can get what they need, and the measures taken by pharmacy benefit managers, or PBMs, to steer patients to higher-priced, profit-generating medications. NCL has been a strong advocate for a well-functioning healthcare marketplace, one that offers consumers genuine choice and the information essential to make educated decisions to protect and strengthen their health.

This emphasis on access includes a strong focus on reproductive health and opposing the multiple efforts in Washington, DC and state capitals to block women from utilizing critically-important services. Today, NCL is adhering as strongly as ever to a philosophy integral to its founding, that women must be free to make their own choices.

During the COVID pandemic, NCL prioritized another aspect of its healthcare advocacy efforts, combating misinformation and building confidence in public health efforts. Today, public health is under relentless attack with the public being bombarded with false claims about vaccines and services vital to protecting population health and well-being. During the pandemic, NCL played an important role in getting vaccine misinformation removed from public platforms and continues this work today, partnering with multiple organizations in the Coalition for Trust in Health and Science.

NCL will continue to champion healthcare policies that fall in the intersection of innovation, affordability, accessibility, and equity. This work manifests in multiple ways, from focusing on access to affordable biosimilar medications to educating consumers on how artificial intelligence can be utilized to strengthen health care efficacy.

To proactively help patients protect their own health, NCL’s Script Your Future initiative will continue to elevate public awareness about the importance of medication adherence.

World Day Against Child Labor on Capitol Hill, 2017 (L to R) Reid Maki,
Director of Child Labor Advocacy and Coordinator of the Child Labor
Coalition, Melyssa Sperber, Humanity United, Nobel Peace Prize Laureate
Kailash Satyarthi, Anjali Kochar, Kailash Satyarthi Children’s Foundation of
America, Jo Becker, Human Rights Watch

PROTECTING CHILDREN 

Consider these recent scenarios: a child suffering chemical burns from working with caustic chemicals in an agricultural processing plant; another experiencing severe injuries from getting his arm caught in a conveyor belt; children falling asleep in school after having worked an overnight shift.

Fighting exploitative and dangerous child labor has been critical to the National Consumer League’s history and is integral to its current and future mission. Along the way, the League has won major victories in the early part of the 20th century through passage of the Fair Labor Standards Act, and its protections against child labor.

An important part of this work is raising public awareness. Most people believe that child labor is a problem of society’s early industrial age when, in fact, 160 million children globally are engaged in labor inappropriate for their young ages and, while there was 20 years of progress in which those numbers were going down, they have recently been creeping back up. That makes NCL’s work so very important.

This work has been both offensive and defensive—fighting to close loopholes in the law that allows employers to have children as young as 12 work long hours in back- breaking and sometimes hazardous jobs while, at the same time, fighting efforts in Congress and the states that would further loosen these laws and enable enterprises facing labor shortages to further exploit minors.

There have been important victories – for example, achieving a ban on kids applying hazardous pesticides, and preventing proposed regulations that would allow children to operate difficult patient lifts in nursing homes without supervision – but the work continues, beginning with raising public visibility.

NCL is the driving force in making the public more aware of the pervasiveness of child labor, working closely with journalists who are producing exposés on the issue and shining a spotlight on farms and processing plants that are exposing children to hazardous labor resulting in serious, life-threatening injuries. In 2023, NCL interviewed with over 120 media outlets, elevating the visibility that helps drive public policy.

And that public policy is percolating. NCL is working closely with members of Congress to raise the currently-too-low fines imposed on employers that violate child labor laws and is forming partnerships in multiple states to fight ongoing efforts by trade associations to weaken the existing laws and regulations protecting children.

Building potent partnerships is at the core of NCL’s work. The organization created the Child Labor Coalition, bringing together nearly 40 major organizations and is currently managing the Campaign to End U.S. Child Labor, engaging on initiatives such as banning child labor in domestic tobacco production.

EMPOWERING TODAY’S AND TOMORROW’S CONSUMERS 

Letting kids be kids and not fodder for a global economy in search of working bodies will continue to be at the core of NCL’s mission. These are challenging times for consumers. In recent years, changing regulations and the growth of corporate oligopolies have made households feel like the deck is stacked against them. NCL is an ally to consumers nationwide, making sure they are protected against unfair and predatory practices and working to improve their lives while, at the same time, preparing future generations of consumers to be better empowered to protect themselves.

NCL has exerted its influence with a broad array of industries, such as the airline industry where NCL has fought for the establishment of stronger protections for airline passengers, getting family seating fees outlawed, rules to keep vouchers from expiring, and enabling those experiencing canceled and delayed flights to receive swifter refunds.

For fifteen years, NCL has taken on the fight for a fairer live event industry, fighting back against monopolistic ticketing giants and unscrupulous ticket resellers. Thanks to NCL’s advocacy, “ticket bots” were outlawed by Congress. And we are now on the cusp of making fans’ biggest gripe—out-of-control add-on ticket fees—a thing of the past.

From advocating for the use of technology to make automobiles safer to pressing for regulations to ensure the safety of CBD products, NCL will continue to insist that corporations and government make the consumer interest a priority.

NCL’s focus is not only on protecting consumers today, but in forging new generations of consumers well equipped to navigate an increasingly complex environment.

Now in its 30th year, the LifeSmarts program educates young people throughout the country and introduces them to the consumer movement. Structured as a fun competition to engage both students and teachers, LifeSmarts gives the next generation real- world knowledge on subjects including personal finance, consumer rights and responsibilities, environment, technology, and workplace health and safety, while also focusing on current issues like medication safety and reducing food waste.

LifeSmarts participants take what they learn and share it with peers, parents, and even grandparents. There are households across the country more financially secure today because of what students have taken away from the LifeSmarts program.

As a former winner from Frederick County, Maryland said, “I use LifeSmarts lessons every day, in every purchase I make from grocery shopping to car buying, when I compare terms on a credit card or find the best interest rates on loans. I learned how to spot email scams, fake websites, and probably a hundred other things I didn’t even realize I learned in LifeSmarts.” 

 

Hospitals and PBMs hijack discount drug program

January 6, 2025: On this episode of NCL’s “We Can Do this” podcast, National Consumers League CEO Sally Greenberg speaks with Amy Hinojosa, President and CEO of Mana, a National Latina Organization, and Dr. Ge Bai, an expert on health care accounting, finance, and policy at Johns Hopkins University, regarding a shocking lack of transparency for a program that has more than doubled in cost reaching more than $120 Billion in 2022.

Congress must protect consumers from PBM abuse

By Sally Greenberg, Chief Executive Officer

The post-election lame duck session of Congress could be one of the most influential for consumers – if our elected officials are willing to act. As Americans struggle with high prescription drug costs, insurance middlemen pharmacy benefit managers (PBMs) siphon dollars from the drug pricing system into their own pockets. Two bills sitting in Congress aim to change this by increasing transparency, ensuring PBM rebates are passed directly to consumers, and disconnecting PBM profits from the price of medicines.

S. 3973: The Pharmacy Benefit Manager Transparency and Accountability Act, would require PBMs to pass on rebates from drug manufacturers directly to consumers, ensuring they benefit from cost savings at the point of sale. It also delinks PBM profits from drug prices, eliminating the incentive to drive up costs.

S. 3430: The Prescription Drug Price Relief and Consumer Protection Act establishes stronger regulations on PBMs, ensuring transparency in drug pricing and rebate negotiations, and making sure PBMs act in the best interests of consumers.

These bills will create a much fairer system, ensuring that savings reach consumers and medications are made more affordable. Congress must advance these bills this year to protect consumers from PBM exploitation now and lay the groundwork for additional healthcare reforms next session.

Although this session – and year – is coming to a close, meaningful healthcare reforms that directly benefit consumers can start now.

As election looms, regulators can act now to help consumers save at the pharmacy counter

By Sally Greenberg, Chief Executive Officer, National Consumers League

Now that we are a mere 15 days away from the election, all attention is unsurprisingly laser-focused on the outcome of the general election. Surprisingly, however, both candidates have made it clear that one of the leading healthcare issues on the ballot is the future of the Affordable Care Act (ACA). Ten years after its enactment, the ACA has become intertwined with the very fabric of the healthcare landscape in the US and thus requires federal agencies to regularly revisit the statutes to ensure it is fulfilling its original intent.

Now that the current administration has released proposed rulemaking on core provisions of the ACA, it has become more important than ever to add statutes to address a loophole in the essential health benefits (EHB) provision of the ACA. There is no better time for three federal agencies – the Department of Treasury, Department of Labor, and Department of Health and Human Services – to change language in the ACA that is constantly exploited by profit-seeking insurers, producing severe access and affordability barriers for patients and undermining the original intent of the ACA.

The loophole goes something like this: Essential health benefits are a central pillar of the ACA and provide affordability protections to Americans by ensuring that everyone in the individual and small group health insurance markets has access to coverage that actually covers the services they need. These essential health benefits fall into ten categories, one of which is prescription drugs.

If a patient pays out-of-pocket for their prescription (an essential health benefit), that dollar amount counts towards their out-of-pocket maximum. Once they hit the out-of-pocket cost maximum set by the ACA, insurance kicks in and covers the remainder of their out-of-pocket costs. However, insurers and pharmacy benefit managers (PBMs) are designating some specialty prescriptions to be “non-essential” – regardless of whether a patient needs them to stay alive. Once labeled “non-essential,” the patient is no longer protected by the out-of-pocket maximum set by the ACA.

What does this look like in practice? A patient may spend money on lifesaving medications that don’t count toward their out-of-pocket maximum. All year, a patient could pay out-of-pocket for prescriptions but never reach their maximum and see their insurance kick in. This saves a few bucks for insurers and PBMs but imposes massive financial burdens for patients who would otherwise be protected under the ACA. The EHB loophole forces patients to pay more out-of-pocket, a situation that circumvents the original intent of the law — which, as a reminder, is to keep drug costs affordable for consumers.

How can we close this loophole? The Department of Treasury, Department of Labor, and Department of Health and Human Services could act now. The tri-agencies can integrate language to close the EHB loophole into the Notice of Benefit and Payment Parameters (NBPP) to clarify that any service covered by a health plan is defined as an EHB.

Both of the frontrunners of the 2024 presidential election have signaled their intent to find solutions that lower prescription drug costs for Americans. While the country braces for the ripple effects of a new administration regardless of the results, regulators should close the EHB loophole to protect consumer access to treatments in line with the original intent of the ACA – affordable and accessible care for patients.

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 About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

National Consumers League statement on FTC action against Big Three PBMs

September 20, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, DC – The National Consumers League (NCL), America’s pioneering consumer advocacy organization, today applauds the Federal Trade Commission (FTC) for bringing action against the three largest prescription drug benefit managers (PBMs) and affiliated group purchasing organizations (GPOs). The FTC’s administrative complaint states that PBMs have engaged in anticompetitive and unfair rebate practices, inflating the list prices of insulin, lining their pockets, and transferring the costs to patients.

The following statement is attributable to NCL’s Chief Executive Officer Sally Greenberg:

“We applaud the FTC for its continued actions and investigation into PBMs. This latest action reinforces the role PBMs play in creating consumers high out-of-pocket costs of medicines consumers face. Caremark Rx, Express Scripts, and OptumRX administer four-fifths of all prescriptions within the states, and prioritizing their profits over the patients’ wellbeing directly impact why 25 percent of insulin patients are unable to afford their medication.”

The FTC’s press release about the administrative complaint can be read here.

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 About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

PBMs are driving the increase in out-of-pocket healthcare costs for consumers, says NCL

July 23, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, DC – The National Consumers League (NCL) today submitted a letter to both the Republican and Democratic chairs of the House Committee on Oversight and Accountability expressing concerns about pharmacy benefit managers (PBMs) driving the increase in out-of-pocket healthcare costs for American consumers. The letter was submitted just as the committee was conducting a hearing with top executives from Express Scripts, CVS Caremark, and Optum Rx.

The following statement is attributable to NCL’s Chief Executive Officer Sally Greenberg:

“We are concerned that these anti-consumer practices are putting the profits of insurance companies and their PBMs before patients, local pharmacies, employers, and state governments. Congress has an opportunity to review these corporate practices and work to ensure a reduced market power, thus minimizing the incentives for PBMs to steer patients towards higher-priced medicines, claim higher and higher rebates to fatten their bottom line, and ultimately driving independent pharmacies out of business.”

The full letter can be accessed here.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL statement on FTC interim report on PBMs

July 10, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, DC – The National Consumers League (NCL) today applauds the Federal Trade Commission’s (FTC) interim staff report on prescription drug middlemen, pharmacy benefit managers (PBMs). The report details how PBMs profit at the expense of patients, inflating drug costs and squeezing Main Street pharmacies.

The following statement is attributable to NCL’s Robin Strongin, Senior Director of Health Policy:

“The FTC’s continued investigation into PBMs, and this latest report, shows promising momentum in addressing the high out-of-pocket costs of medicines consumers face. Countless investigations such as this, as well as news coverage, patient stories, and pharmacy closures across the country, prove again and again that PBMs are doing more harm than good. As the report shows, the vertical integration of PBMs has allowed them to rake in profits at the expense of patients and independent pharmacies.

“That said, we also recognize that this interim report and its findings don’t go far enough. It’s well past time to examine and address the overall corporatization of health care, including the vertical integration of the industry. In the current set-up, the biggest winners are the health insurance corporations that own PBMs, doctors, pharmacies and more. The biggest losers? Consumers.

“While NCL is encouraged that the FTC is working to hold PBMs accountable, we also encourage the need for meaningful reform that helps and doesn’t harm consumers.”

The full report can be accessed here.

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 About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Patients can’t afford Congress delaying PBM reform another year

By Robin Strongin, Senior Director of Health Policy

As the 2024 political campaigns intensify, we’re going to be hearing a lot from candidates about what they’re going to do to make healthcare more affordable. The problem is, we’re dealing with high out-of-pocket costs right now and we shouldn’t have to wait until after another election for something to be done about them, especially when the current Congress has solutions today.

As I navigate my husband’s care through his battle with Lewy body dementia and speak to other patients and their loved ones, I have become all too familiar with the practices certain players in our healthcare system use to boost their already extraordinary profits at our expense. Pharmacy benefit managers, or PBMs, are a prime example of this and we urgently need legislation to rein in their actions that are affecting both the costs we pay for care and access to the medicines our families need.

Several committees in both the U.S. House and Senate have been working on PBM reform legislation for months and there are multiple bills that could be passed now and sent to President Biden for his signature. With the time they will be taking off for campaigning, lawmakers have very few days left that they will be in Washington, D.C. this year. It would be all too easy for them to kick this can down the road and let the next Congress deal with it.

We need to raise our voices to demand that they don’t pass on this opportunity to make a difference.

There are two elements of PBM reform that could have an immediate impact on costs and prescription drug accessibility that Congress should pass without hesitation:

  • Disconnect PBM profits from drug prices. Right now, PBMs generate revenues from the rebates they demand from drug manufacturers. The higher the drug costs, the more they make in rebates and, consequently, they steer patients to medicines that cost more and block access to lower-priced generics and biosimilars. Enough is enough. Pass legislation that will have PBMs paid a flat fee for their services and remove the perverse incentives that are forcing patients to pay more and that place financial interests between patients and their healthcare providers.
  • Mandate that the PBMs pass along those negotiated rebates and discounts to consumers. Currently, these middlemen are moving those dollars into their own pockets. These savings should be going to patients at the pharmacy counter. It’s just common sense.

These are urgent issues that affect the lives and pocketbooks of millions of Americans. Yes, it’s great that politicians are making promises about how they will fix healthcare costs next year, but we need action now. Congress must pass PBM reform legislation before they adjourn this year.