PBMs: Who They Are and Why We Need Reform Now

What Are PBMs?

PBM stands for Pharmacy Benefit Manager. These corporate middlemen sit between health insurers, drug providers, and patients. They play a critical role in setting medication prices—and often, they’re overcharging us while pocketing profits. Using tactics like administrative fees, spread pricing, and shared savings, PBMs inflate drug prices, making medications unaffordable for too many Americans. They also have the power to decide which drugs we can access, restricting the essential treatments we need. They are an unregulated force in the healthcare market that needs to be reformed.

Why PBM Reform Matters

The demand for change is clear. The public and lawmakers agree: we need to reform these corporate middlemen driving up prescription drug costs.

• Rising Prices Hurt American Families: PBMs and big insurance companies are pushing drug prices higher, leaving patients to face impossible choices at the pharmacy.
• Profits Over Patients: PBMs link their profits directly to drug costs and keep savings for themselves instead of passing them on to those who need it most—America’s seniors.
• Unfair Practices Must End: Increased premiums and PBM profit schemes mean it’s more critical than ever to act. No one should have to choose between buying food and getting life-saving medications.

Take Action Now

It’s time for Congress to act and deliver on the bipartisan call for PBM reform. Let’s make sure savings go to patients—not to corporate middlemen.

Contact your representatives in Congress today. Ask them to pass S. 2973 / S. 3430 to pass on real savings to patients.

Call Congress: 202-224-3121

Learn More

Read how PBMs impact medication costs and why reform is urgently needed:

• 5 Things To Know About Pharmacy Benefit Managers – Center for American Progress (link)
• The PBM Bills in Play for a Lame Duck (link)
• Lawmakers Unveil PBM Reform Bill Amid Rising Drug Costs (link)
• House Lawmakers Slam Pharmacy Middlemen Over Sky-High Drug Prices (link)