PBMs are leveraging their position as federal contractors/subcontractors to act as price setters, manipulate markets, and engage in unfair practices that pad their profits while harming independent and other retail pharmacies, patients, and taxpayers.

Patients, community pharmacies, and taxpayers continue to suffer at the hands of PBMs while drug prices skyrocket. Abundant evidence of large PBM practices and abuses in federal healthcare plans includes: • Hundreds of millions of dollars in spread pricing markup in Medicaid managed care plans • A large PBM in Part D increased generic drug prices by 51% for seniors at the counter despite those generics’ prices deflating more than 8% during the same period • Over $60 billion in drug manufacturing and pharmacy discounts denied to Medicare Part D beneficiaries in 2021 • Large PBMs paying their affiliated pharmacies more in Medicare Part D • PBMs mandating patients receive expensive brand name drugs when cheaper generic drugs were prescribed and available in Medicare Part D, driving up drug costs for seniors at the pharmacy counter and for taxpayers • Over $39 million in PBM overcharges in the American Postal Workers Union Health Plan administered of the Federal Employee Health Benefit Program While PBM practices are opaque and complex, the solutions provided in PFB and PFB Oversight offer sensible and simple solutions that will lower costs for patients at the pharmacy counter while paying retail pharmacies transparently and fairly.

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