May 13, 2026

RELEASE: Auchincloss, Warren, Harshbarger, Hawley Reintroduce Bipartisan Legislation to Rein in Pharmacy Benefit Managers (PBMs), Cut Drug Costs

FOR IMMEDIATE RELEASE

Contact: Georgina.Burros@mail.house.gov (Auchincloss)

RELEASE: Auchincloss, Warren, Harshbarger, Hawley Reintroduce Bipartisan Legislation to Rein in Pharmacy Benefit Managers (PBMs), Cut Drug Costs

WASHINGTON, D.C. – Representatives Jake Auchincloss (D-MA) and Diana Harshbarger (R-TN), alongside Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO), reintroduced the Patients Before Monopolies (PBM) Act with expanded bipartisan support to rein in drug pricing middlemen, known as pharmacy benefit managers (PBMs), from enriching themselves and crushing competition at the expense of patients and independent pharmacies.

In the 119th Congress, new original cosponsors include Senators John Fetterman (D-PA) and Roger Marshall (R-KS), alongside Representatives Greg Landsman (D-OH) and Buddy Carter (R-GA) of the Committee on Energy and Commerce, and Jerry Nadler (D-NY) and Troy Nehls (R-TX) of the Judiciary Committee.

Since the PBM Act was first introduced in 2024, states across the country have sought to break up these giant conglomerates. In early 2025, Arkansas passed a law to prevent the joint ownership of PBMs and pharmacies. Later that year, 39 state attorneys general wrote a letter urging Congress to “pass[] an act prohibiting PBMs, their parent companies, or affiliates from owning or operating pharmacies.” In April, Tennessee lawmakers passed a law to ban joint ownership of PBMs and pharmacies, and the Tennessee Governor is expected to sign the bill into law as soon as this week. This growing bipartisan momentum in support of the goals of the PBM Act from across the nation sends an important signal to Congress that the work to rein in PBMs is not yet finished.

Over the past decade, PBMs have morphed into large health care conglomerates that exercise control over nearly every link of the prescription drug delivery chain. Today, the largest health care conglomerates each own a PBM — which pays for pharmacy services — as well as the pharmacy chains that provide those services. This inherent conflict of interest results in higher drug costs for patients and fewer independent pharmacies, but bigger profits for the corporate health care giants.

The Patients Before Monopolies (PBM) Act will address this by:

  • Prohibiting a parent company of a PBM or an insurer from owning a pharmacy business;

  • Requiring that a parent company in violation of the PBM Act divest its pharmacy business within one year of the bill’s enactment;

  • Creating automatic penalties if a company fails to divest in a timely manner, including disgorgement of profits and forced sales of assets in the event of noncompliance;

  • Enabling the Federal Trade Commission (FTC), Department of Health and Human Services (HHS), Antitrust Division of the Department of Justice (DOJ), and state attorneys general to bring lawsuits requiring violators of the PBM Act to divest their pharmacy business and disgorge any revenue received during the period of such violation;

  • Enabling private parties, including independent pharmacists, to bring lawsuits against violators of the bill, and secure treble damages in successful lawsuits;

  • Directing the FTC to distribute any revenue raised by penalties to harmed communities, including consumers overcharged at vertically integrated pharmacies; and

  • Allowing the FTC and DOJ to review and block future actions that would recreate the anticompetitive conditions addressed by the bill or harm the public interest.

“Like so many small business owners in America, independent pharmacists are working hard and playing by the rules but getting ripped off by monopolies,” said Rep. Auchincloss. “The PBM industry is rife with self-dealing and price gouging. Congress made modest but meaningful reforms earlier this year, and now the next step is banning PBMs from owning pharmacies. It's an unacceptable conflict of interest and yet another example of the vertical integration in health care that is raising prices for patients.”

“Our PBM Act is gaining momentum because people are realizing that you can’t lower health care costs without tackling corporate greed in the health care system,” said Senator Warren. “It’s time we finally rein in the health care middlemen that are jacking up drug costs and driving small pharmacies out of business.”

“Americans are paying more and more for healthcare while seeing less in return. PBMs are at the center of a broken system that rewards middlemen while driving up costs for patients and pushing out independent pharmacies,” said Senator Hawley. “Working Americans deserve better. This legislation is a major step toward restoring transparency and making healthcare more affordable for every American.”

“As a lifelong pharmacist, I’ve seen firsthand how PBMs game the system. When the same corporate giant that sets reimbursement rates also owns the pharmacy collecting them, that’s not a free market—it’s a rigged one,” said Rep. Diana Harshbarger. “We have antitrust laws for a reason. When monopolies squeeze out independent pharmacies, raise costs for patients, and reduce consumer choice, Congress has a duty to restore fair competition. The Patients Before Monopolies Act ends this blatant conflict of interest once and for all.”

"Pharmacy Benefit Managers drive prices up for patients and run independent pharmacies out of business,” said Rep. Jerry Nadler. “These greedy corporations have dodged regulation at the cost of American patients and small businesses for far too long. For my entire career, I have fought to make healthcare accessible for all Americans, and I am proud to support this bill reining in PBMs and enforcing fair business practices.”

“We’re taking on these giant healthcare companies to get prescription drug prices down, and to protect our family-owned pharmacies,” said Rep. Greg Landsman. “These companies make billions in part because they control so much of the market, but our bill will change that and put patients first.”

“Pharmacy Benefit Managers (PBMs) have been stealing hope and health from the American people for decades, inflating prescription drug costs, forcing pharmacy closures, and blocking access to medications.” As a pharmacist from coastal Georgia, I came to Congress with the goal of building a health care system that puts patients before profits,” said Congressman Buddy Carter. “I proudly support the Patients Before Monopolies Act, which builds on my previous PBM legislation signed into law last January, to continue cracking down on PBMs’ anti-competitive practices.”

“Americans are sick and tired of giant corporations putting profits over patients,” said Congressman Troy Nehls. “For too long, the largest Pharmacy Benefit Managers (PBMs) have manipulated the prescription drug market supply chain, crushed independent pharmacies, and have driven up costs for patients. I’m proud to be an original cosponsor on this bipartisan legislation to restore accountability, protect local pharmacies, and lower costs for American families.”

“PBM vertical integration with retail, mail-order, and specialty pharmacies has led to reduced patient choice and higher drug prices for patients and payers. The Patients Before Monopolies Act cuts out PBM conflicts of interest at their root by breaking up PBM ownership of and affiliation with pharmacies. APCI commends Senators Warren and Hawley, and Representatives Harshbarger and Auchincloss on fighting against PBM anticompetitive practices and advancing policies that will restore competition to the prescription drug marketplace,” said Greg Reybold, Vice President of Public Policy, American Pharmacy Cooperative, Inc.

“With the reintroduction of the Patients Before Monopolies Act (PBM Act), we are grateful to Senators Warren and Hawley and Representatives Harshbarger and Auchincloss for standing up for patients and pharmacies. For too long, the largest health insurers have resorted to fear and intimidation tactics, expending substantial resources in order to scare and confuse the public into thinking PBM reform will be bad for them. With this new legislation, PBMs will finally be held accountable for years of abusing their role as ‘benefits administrators’ to undercut pharmacy providers while also profiteering off the backs of unsuspecting employers, patients and taxpayers,” said Monique Whitney, Executive Director, Pharmacists United for Truth and Transparency.

“Divesting PBMs from owning pharmacies will stop the conflict of interest that drives patients into PBM-owned specialty pharmacies where specialty generic drug prices are kept artificially high. The Patients Before Monopolies Act levels the playing field for community pharmacists and finally puts patients ahead of PBM profits,” said Madelaine Feldman, MD, FACR; Rheumatologist; Vice President, Advocacy & Government Affairs; Coalition of State Rheumatology Organizations; New Orleans, Louisiana.

“Giant PBMs and insurers owning their own pharmacies has driven independent pharmacies out of business and reduced patient access to quality care. The Patients Before Monopolies Act addresses the root cause of this problem — consolidated market power — by eliminating the inherent conflicts of interest within the 'Big Three' PBM business model,” said Morgan Harper, Director of Policy and Advocacy, American Economic Liberties Project. “We are thrilled to see Sen. Warren and Sen. Hawley and Reps. Harshbarger and Auchincloss lead this bipartisan effort to lower drug costs, protect independent retail pharmacies, improve patient access to care, and break up Big Medicine.”

“The Patients Before Monopolies Act takes an important step toward restoring integrity and competition in healthcare by ending the deeply flawed model where PBMs and insurers can own the very providers they oversee and reimburse,” said Robert Levin, MD, President, Alliance for Transparent & Affordable Prescriptions. “When the same corporations control the financing, administration, and delivery of care, patients and independent providers are put at a disadvantage. Healthcare decisions should be driven by what is best for patients, not by vertically integrated corporations maximizing profits through self-preferencing and consolidation.”

“American Pharmacies strongly supports the Patients Before Monopolies Act. When PBMs own pharmacies, the resulting self-dealing and conflicts of interest distort the marketplace and too often undermine affordable, accessible, patient-centered care. American Pharmacies and our 700 independent pharmacy members across the country thank the bill’s sponsors for their leadership in confronting one of the root causes of rising costs and barriers to care,” said Steve Hoffart, R.Ph., Chairman, American Pharmacies.

“PBMs have a choice — operate as a PBM or operate as a pharmacy, but you can’t have it both ways,” said B. Douglas Hoey, pharmacist, MBA, CEO, National Community Pharmacists Association. “Having both functions under one roof is a huge conflict of interest and drives up prescription drug prices. The Patients Before Monopolies Act is critical in supporting patients and independent pharmacies and restoring a free market. NCPA is proud to support it and thanks Reps. Harshbarger, Auchincloss, Carter, Nadler, and Nehls, and Sens. Warren, Hawley, Marshall and Fetterman for their leadership.”