Attorney General Miyares Joins Bipartisan Coalition Urging Congressional Action on Pharmacy Benefit Manager Reform

~ AG Miyares Remains Committed to Prioritizing Patients Over Profit-Driven Corporations ~

RICHMOND, Va. – Attorney General Jason Miyares today joined a bipartisan coalition of 38 other attorneys general in urging Congress to take decisive action to reform the way pharmacy benefit managers (PBMs) conduct business and bring more transparency to their work. 

A PBM is a third-party company that functions as an intermediary between insurance providers and pharmaceutical manufacturers, ostensibly to reduce the cost of prescription medication for its clients. It typically negotiates discounts and rebates with drug manufacturers, contracts with pharmacies, and develops and maintains drug formularies, or lists of covered drugs. Because a PBM ultimately decides which drugs it covers, it can bargain for rebates from drug manufacturers who want to get their products on its “formularies,” or lists of covered drugs. As a result of this leverage, PBMs essentially force drug manufacturers to raise list prices in order to provide ever-growing rebates.

“In the absence of meaningful federal regulations, Virginia enacted laws to protect consumers from exploitative PBM practices – legislation I supported while serving in the General Assembly. It’s time for Congress to step up and take legislative action against PBMs’ unjustifiable increases in drug prices and establish structured systems to increase the transparency of their practices,” said Attorney General Miyares.  

Specifically, the coalition highlights three bills as crucial pieces of legislation that offer necessary reforms:

• The DRUG Act (S1542/HR6283)
• Protecting Patients Against PBM Abuses Act (HR2880)
• The Lower Costs, More Transparency Act (HR5378)

Passing such legislation would encompass the obligation for PBMs to furnish pricing data to health plans and federal and state regulators in a standardized format. Such measures will empower health plans to negotiate more advantageous agreements with PBMs and enable regulators to more effectively hold PBMs accountable for their actions.

Attorney General Miyares was joined by the attorneys general of Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaii, Illinois, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virgin Islands, Wisconsin, and Wyoming.

Click here to read the letter.

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