Over 100 organizations representing millions of employers and patients are calling on Congress to enact comprehensive Pharmacy Benefit Manager (PBM) reform legislation before the end of 2025.
The coalition highlights that three PBMs now control nearly 80% of prescription drug claims in the U.S., creating a concentrated market that drives up costs, limits patient choice, and forces Americans to choose between their health and financial stability.
Key Reforms Being Sought:
- Full transparency of PBM business practices and financial arrangements
- Ban on spread pricing (where PBMs profit from the difference between what they charge insurers and pay pharmacies)
- 100% pass-through of manufacturer rebates and discounts to plan sponsors and patients
- De-linking PBM compensation from drug prices
The letter specifically urges Congress to advance PBM policies from a December 2024 bipartisan health care package that nearly became law. The coalition emphasizes that over 160 million Americans with employer-sponsored coverage deserve transparency about how their health care dollars are spent, with savings directed to them rather than PBM profits.
The signatories include patient advocacy groups, employer coalitions, pharmacy associations, and disease-specific organizations spanning the political spectrum—demonstrating the broad bipartisan support for these reforms.