In The News

Originally Published in The Augusta Chronicle
By: Joe Hotchkiss

Think your prescription drugs cost too much? A bill recently introduced in Congress by Augusta's congressman seeks to keep profit-minded middlemen in check.

The PBM Kickback Prohibition Act aims at pharmacy benefit managers. For decades, PBMs have helped insurers and employers administrate their prescription drug plans.

PBMs reimburse pharmacies for the drugs they dispense. But PBMs also often charge additional fees to health plans and pay pharmacies less than what they charge insurers, pocketing the difference.

U.S. House Rep. Rick Allen, the bill's sponsor, calls them "kickbacks."

His bill, if signed into law, would "rein in PBMs by ending kickbacks that deceptively raise the cost of health insurance for patients, workers and families," Allen said in a statement.

"All Georgians know a friend or loved one that has fallen victim to unaffordable prescription drug costs, and in many cases, that can be attributed to PBMs," Allen told The Augusta Chronicle. "My legislation would end kickbacks and the pay-for-play tactics employed by PBMs that drive up prices for patients and hardworking families. If we can get the PBM Kickback Prohibition Act over the finish line, Georgians will see cheaper price tags for the medications they need."

Allen chairs the Health, Employment, Labor, and Pensions Subcommittee, part of the House Committee on Education and Workforce.

"If we’re serious about lowering health care costs, we have to take on the middlemen driving prices higher," said U.S. Rep. Tim Walberg of Michigan, the committee's chairman. "Banning kickbacks paid by pharmacy benefit managers to a medical plan’s advisor or consultant is a commonsense reform that protects workers, employers, and patients. Simply put, Rep. Allen’s bill makes sure decisions are made based on what’s best for patients and plan sponsors, not who’s paying the biggest kickback."

In 2024, the Federal Trade Commission sued America's three largest PBMs, alleging unfair rebating that the FTC said inflated the list price of insulin.