WASHINGTON (December 12, 2024) – AIDS Healthcare Foundation (AHF) strongly supports an effort unfolding on Capitol Hill that would prohibit health insurers and their pharmacy benefits managers (PBMs) from also owning pharmacies.
The Patients Before Monopolies Act was introduced on December 11 by a bipartisan group of legislators including Sen. Elizabeth Warren, D-Mass., Sen. Josh Hawley, R-Mo., Rep. Diana Harshbarger, R-Tenn., and Rep. Jake Auchincloss, D-Mass.
The bill represents lawmakers’ most aggressive legislative attempt to regulate PBMs in recent years; however, The New York Times reports that it uncertain whether the bill will gain much traction in the House and Senate.
Becker’s Hospital Review notes that CVS’ Caremark, Cigna’s Express Scripts and UnitedHealth’s OptumRx represent the three largest PBMs in the U.S., collectively controlling about 80% of all prescription claims.
“Thanks to self-serving corporate vertical integration over the past decade, these three healthcare goliaths now act as gatekeeper at every level of the patient care continuum,” said Tom Myers, AHF’s General Counsel and Chief of Public Affairs. “With a stranglehold on access to care, including pharmacy services, they are squeezing many mom-and-pop and specialty pharmacies to the point where many have been forced to close. We applaud this legislative effort—a bipartisan recognition that monopolies like this don’t lower costs, and actually harm patients.”
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