On Feb. 11, the House Energy and Commerce Health Subcommittee held a hearing, “Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain.” The hearing featured nine witnesses representing major players in the prescription drug supply chain, including manufacturers, pharmacy benefit managers (PBMs), group purchasing organizations, pharmacists, and insurers.
Throughout the hearing, committee members on both sides of the aisle scrutinized PBMs’ role in the prescription drug supply chain, raising concerns about how consolidation and vertical integration with insurers may impact market competition, and consequently, prescription drug prices. Members also emphasized the importance of improved visibility into PBMs’ business practices, including access to prescription drug claims data for employers and the disclosure of spread pricing practices. Notably, the fiscal year 2026 Labor-Health and Human Services-Education appropriations bill, which was signed into law on Feb. 3, contained several bipartisan measures aimed at reforming the PBM industry [refer to Washington Highlights, Feb. 6]. These new policies require that Medicare Part D plans compensate PBMs through flat, bona fide service fees, rather than tying payments to the list price of drugs. They also require PBMs to provide employer health plans with additional data regarding drug spending, drug rebates, spread pricing arrangements, and formulary placement rationale.
This hearing was part of an ongoing series examining health care affordability, which began with a Jan. 22 hearing on health insurance affordability and insurer practices [refer to Washington Highlights, Jan. 23].