October 17, 2023

Understanding PBM Reform: A Guide to Congress’s Proposals to Enact Federal PBM Reform Legislation

After the enactment of the Inflation Reduction Act, which enables Medicare to negotiate the price of certain prescription drugs, Congress is again attempting to lower the cost of prescription drugs. This time—in a rare bipartisan effort—Congress is focusing on pharmacy benefit managers (PBMs). PBMs are third-party “middlemen” contracted by insurance plans to manage prescription drug benefits, including by negotiating prescription drug discounts with manufacturers. Over the last decade, PBMs have come under intense scrutiny from consumers, prescription drug manufacturers, and state and federal policymakers. A number of state-level policies have been enacted. Action at the federal level, however, has been minimal. Until now.

In a new webinar, Manatt Health will explore the history of PBM reform on Capitol Hill, provide an overview of key policy levers Congress is focused on, and examine the legislative proposals both the House and Senate are advancing. Click here to register for the free, CLE-eligible program. Key topics include:

  • A recent history of PBM reform on Capitol Hill, including past attempts to regulate
  • An overview of key PBM-reform policy concepts, such as spread pricing, delinking, transparency, rebate pass-through and vertical integration, among others
  • The key legislative proposals in both the House and Senate, including describing the specific policy proposals within each bill and how they would regulate PBMs

View recording here