Congress Has a Chance to Finally Hold PBMs Accountable

Patients deserve a prescription drug market that is open, honest, and affordable. For too long, pharmacy benefit managers have operated behind a wall of secrecy that hides how they make money and why drug costs keep climbing. The bipartisan Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act, introduced in the U.S. Senate by Sens. Ron Wyden and Mike Crapo, offers a clear path to fixing that.

This bill tackles one of the biggest drivers of high drug prices: opaque PBM business practices that reward higher-priced drugs, penalize independent pharmacies, and raise costs for families. The proposal bans spread pricing in Medicaid, ends the shell-game of arbitrary fees, and requires PBMs to pass through transparent pharmacy reimbursement. It makes sure federal programs stop steering seniors and low-income families toward more expensive medicines just because PBMs profit from them.

The bill also modernizes standards for essential community pharmacies. These pharmacies serve millions of Americans in small towns and underserved neighborhoods. When PBMs squeeze them with hidden clawbacks and unpredictable payment terms, those communities lose access to care. The Senate bill puts guardrails in place that stabilize the pharmacy safety net by requiring honest reimbursement, timely payments, and clear reporting.

Just as important, the bill creates real auditing and enforcement tools. PBMs will no longer be able to hide behind dense contracts and undisclosed revenue streams. Federal watchdogs will finally have the authority to track where the money goes and ensure that savings flow to patients, not middlemen.

This is a rare moment of bipartisan agreement. Lawmakers on both sides of the aisle see the same problem: a broken market that rewards opacity and punishes patients. They deserve credit for listening to employers, independent pharmacists, and families who have warned about PBM abuses for years.

Congress should move quickly. The longer PBM business practices stay in the shadows, the longer patients will pay the price. The Senate bill brings sunlight, accountability, and real relief at the pharmacy counter. It is a smart, practical reform that will lower costs and restore trust across the prescription drug supply chain.