About the PBM Problem

Problems in the Market

How PBMs Affect Cost

Our Goals    

Our Goals

Increase regulatory attention to PBMs: While the recent CVS-Aetna merger did bring the PBM market under regulatory scrutiny, there is still not enough oversight of the industry. We want to make the PBM market a high priority for regulators by accomplishing the following goals:

• Convince the FTC to hold hearings on PBM-related issues, focusing on how consumers are impacted. Such hearings would go a long way to highlight deceptive practices by PBMs and educate health plans about the importance of paying due diligence to their selection of PBM.
• Convince the FTC to open up an investigation into harmful PBM practices and how they are negatively affecting the market. Public hearings would pave the way for such an investigation and ultimately the FTC would hopefully take action to eliminate PBMs' ability to deceive and cheat their customers.
  
  

Encourage legislators to take action: Similarly, we want to increase the amount of attention legislators pay to PBMs and encourage them to pass federal PBM legislation. Currently, dozens of states have passed legislation regulating various aspects of PBM operations, actions that need to be reflected and implemented at the national level. 

Educate Health Plans about the importance of using a transparent PBM:  We want to encourage health plans to be informed about the deceptive practices many PBMs employ so that they decide to contract with healthy, transparent PBMs. Ideally, by educating health plans we can increase pressure on PBMs to stop their deplorable tactics and act competitively.