Putting Patients First: New Reforms Give Patients Their Money, Their Prices, and More Options

Washington, D.C.—Today, Hannah Anderson, Director of Healthy America Policy and Senior Director of Policy at the America First Policy Institute (AFPI), issued the following statement in response to congressional passage of a government funding package that includes pharmacy benefit manager (PBM) reforms:

“This legislation takes an important step towards putting patients—not middlemen—in charge of their healthcare dollars and decisions. For too long, patients have been forced to navigate a system where costs are hidden, competition is distorted, and intermediaries profit. Meanwhile, as PBMs operate in the shadows, the patient has no idea how much of a cut middlemen are receiving from their medication, or that another nearby pharmacy may offer a lower-cost option.

Simply, the bill requires PBMs to provide an itemized receipt for claims information, like the price of the drug dispensed. The idea that companies—employers—who are purchasing PBM services but are not allowed to know the cost of what they’re buying is simply anti-competitive. It also requires PBMs to provide 100% of the discounts provided by the drug manufacturer (a rebate) to the employer, rather than hiding these discounts away from companies and their employees.

AFPI’s research report mentions an analysis that states that in 2019, PBMs accounted for up to 40 percent of the cost of a prescription drug. They often refuse to provide itemized cost data, keep rebates, and steer patients toward their PBM pharmacies and higher-priced medicines. This isn’t a rare occurrence—it's an unconscionable norm in healthcare.

AFPI applauds patient-first reforms that give them more of their money, their prices, and their options—and that ultimately makes America healthy again. This bill, along with the Great Health Care plan, is a strong start to doing just that. For more information, please visit AmericaFirstPolicy.com.”