Pharmacy Benefit Manager Reform: What’s on the Horizon? (December 2023 Update)

The price of prescription drugs has brought scrutiny to the entire drug supply chain. Congress and other policymakers continue to seek opportunities to lower costs for patients and the federal government. Pharmacy benefit managers (PBMs) are a key stakeholder in the drug supply chain, functioning as intermediaries between insurance providers and pharmaceutical manufacturers.

Congress and other stakeholders are raising questions about PBMs’ operations and their impact on drug prices and out-of-pocket costs for patients. In the 118th Congress, six key committees have advanced legislation that would increase PBM transparency and reporting obligations and modify other business practices. In the House, three committees combined to introduce H.R. 5378, the Lower Costs, More Transparency Act, which passed the House December 11, 2023. Read on as we review and compare policies in the Lower Costs, More Transparency Act and the PBM bills considered individually by the relevant House and Senate committees.

Access the full report.

Leigh Feldman
Leigh offers clients nuanced health policy and legislative affairs insights informed by more than a decade of experience at the Centers for Medicare & Medicaid Services (CMS) and on Capitol Hill. A skilled legislative and regulatory strategist, Leigh helps clients evaluate health policy proposals and anticipate policy changes. Read Leigh Feldman's full bio.


Amy Kelbick
Amy is a highly experienced health policy and advocacy professional who brings the benefit of nearly fifteen years of experience working on Capitol Hill in health-specific policy roles, and as a lobbyist and health policy specialist for a major national advocacy association. Read Amy Kelbick's full bio.


Rachel Stauffer
Rachel is a highly experienced government relations and legislative affairs strategist and advocate who is informed by a solid foundation of health policy knowledge. Prior to joining McDermottPlus, Rachel served as the director of policy and government relations for a health IT contractor, where she developed the company’s first strategic plan for government relations. She grew the company’s profile on Capitol Hill by establishing new relationships with key leaders in the federal, state and military health program space. As a result, the company became an authoritative source on a variety of legislative approaches, especially related to veterans’ health. Read Rachel Stauffer's full bio.


Erica Stocker
Erica Stocker is a skilled policy and advocacy professional who has more than 20 years of experience in Washington, DC — including nearly 10 years working on Capitol Hill in health policy and office leadership roles, and more than a decade as a government relations professional and registered lobbyist. Read Erica Stocker's full bio.


Katie Waldo
Katie is an experienced government relations strategist who helps clients navigate the complex issues surrounding Medicare, Medicaid and the healthcare marketplace. Katie works with clients to represent their needs before the US Congress and the US Department of Health and Human Services (HHS) and its agencies by relying on extensive experience as a policy advisor on the Medicaid and Medicare programs, as well as the 340B program and other aspects of the Public Health Service Act. She anticipates the effects of state and federal policymaking on issues impacting their businesses and crafts proactive and comprehensive legislative strategies.Read Katie Waldo's full bio.

BLOG EDITORS

STAY CONNECTED

TOPICS

ARCHIVES

Top ranked chambers 2022
US leading firm 2022