Cantwell, Grassley Lead Renewed PBM Accountability Push

January 23, 2024

Senators seek results of 18-month federal investigation into Rx middlemen

This week, U.S. Senator Maria Cantwell (D-Wash.), chair of the Senate Committee on Commerce, Science, and Transportation, and Senator Chuck Grassley (R-Iowa) led a letter urging the Federal Trade Commission (FTC) to complete its investigation into the health care industry’s most powerful prescription drug middlemen. The bipartisan senators are also requesting a status update on the investigation. 

Sens. Cantwell and Grassley are joined by Sens. James Lankford (R-Okla.), Susan Collins (R-Maine), Peter Welch (D-Vt.), Cindy Hyde-Smith (R-Miss.), Tommy Tuberville (R-Ala.), Chris Coons (D-Del.), Jerry Moran (R-Kan.), Shelley Moore Capito (R-W.Va.), Jon Tester (D-Mont.), Thom Tillis (R-N.C.), Marsha Blackburn (R-Tenn.) and Mazie Hirono (D-Hawaii). 

“We support the [FTC’s] issuance of a Section 6(b) order and conducting a timely study of pharmacy benefits managers’ (PBM) business practices,” the senators wrote in their letter to FTC Chair Lina Khan. “With the FTC’s inquiry reaching its year-and-a-half mark, we urge the FTC to complete the study without delay. In the interim, we believe it is important to know the status of the study and therefore ask the FTC to issue a progress report.” 

The FTC launched its inquiry into pharmacy benefits managers in June 2022. That October, Sens. Cantwell, Grassley and a bipartisan group of senators called on the FTC to expedite its investigation. Today’s push for answers follows recent committee passage of Cantwell- and Grassley-led measures targeting prescription drug costs and directing heightened PBM oversight. 

  • February 2023: Sen. Cantwell led a Senate Commerce Committee hearing on shining a light on the role pharmacy benefit managers play in the skyrocketing price of prescription drugs.
  • March 2023: The Senate Commerce Committee advanced the Cantwell-Grassley PBM Transparency Act, a bill to authorize the FTC to hold PBMs accountable for unfair or deceptive practices. 
  • February 2023: The Senate Judiciary Committee advanced the Cantwell-Grassley Prescription Drug Pricing for the People Act, a bill to require the FTC to study anti-competitiveness in the health care industry and report back to Congress. 
  • Throughout 2023: The Senate Finance Committee (JulyNovember) and the Health, Education, Labor and Pensions Committee advanced bills to bolster transparency among PBMs. 

PBMs manage every aspect of the prescription drugs benefit process – from setting prescription prices, to deciding which drugs insurance plans cover and how they’re dispensed. Of the six companies under FTC investigation, three control nearly 80 percent of the market. Despite PBMs’ sweeping influence, neither Congress nor the taxpayer has adequate visibility into their operations. By shining a light on PBMs, Cantwell, Grassley and their colleagues are working to identify causes for the skyrocketing prices patients are paying for their prescriptions, as well as solutions to address them.  

Read the full letter HERE.