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WASHINGTON — President Trump has blasted them as “middlemen,” known for their “dishonest double dealing.” Key Democrats decry the industry as a “black box” under a “veil of secrecy.” Pharmaceutical companies, pharmacists, and doctors incessantly pummel them, in ads and in testimony, as the key culprits behind the nation’s rising drug prices.

Now, the “middlemen” — pharmacy benefit managers, entities that aim to help insurance companies negotiate lower drug prices by managing formularies and extracting rebates — will have an unprecedentedly high-profile chance to defend themselves. Five of the industry’s top executives head to Capitol Hill this week for a pair of back-to-back hearings Tuesday and Wednesday. Whether their appearances manage to assuage some of those criticisms — or whether they succumb to tough questions — remains to be seen.


The PBM industry’s Washington tour this week follows a major March hearing at which seven executives from major pharmaceutical companies faced and largely parried a litany of questions about their own industry’s role in the nation’s high drug prices. And both hearings come in the midst of increasingly bipartisan interest in legislation or administration action to lower the price of prescription medicines, plenty of which has focused on curtailing PBM profits.

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  • I hope the members of this congressional hearing did their homework on the
    history of what the PBM’s have done for for years. How the D.O.J could have ever allowed CVS (the pharmacy chain) to buy CAREMARK (the PBM) is unbelievable !
    This is now a company that makes more money than Apple computer co. They are a switch that decides how much they pay themselves and how much they pay every pharmacy in the country. And no one sees this as a conflict ? A portion of their profit
    is acquired by underpaying pharmacies(besides their own of course) They have different MAC (maximum allowable cost) lists for the same patients,depending upon
    which pharmacy fills the prescription. But all this is a deep secret.
    The future existence of independent pharmacy in this country will depend upon the outcome of these hearings. 100% transparency is needed to create a level playing field. That is the only way the dozens of states that got fleeced out of 100’s
    of millions of dollars can never happen again. All independent pharmacies want is a fair dispensing fee and paying acquisition cost(which they know very well).
    Why should a customer be forced to use a PBM’s mail order house?Not fair, waste of money and a cash cow for the PBM’s. Spread pricing is such a rip off to the government,the client and the patient. The only one who makes out is the PBM.
    These hearings should be very interesting…. Let’s see what happens…

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