A group of bipartisan lawmakers has introduced the Patients Before Monopolies Act. Led by Senators Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.), the senate bill targets pharmacy benefit managers (PBMs) and their control over affiliated pharmacies. It demands companies owning both PBMs and pharmacies to divest their pharmacy operations within three years, per the Wall Street Journal.
PBMs negotiate drug prices between insurers, manufacturers, and pharmacies. Critics say this arrangement inflates costs and harms independent pharmacies. The largest PBMs—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (UnitedHealth)—are linked to major insurers, raising conflict-of-interest concerns.
“PBMs have manipulated the market to enrich themselves—hiking up drug costs, cheating employers, and driving small pharmacies out of business,” Warren said. “My new bipartisan bill will untangle these conflicts of interest by reining in these middlemen.”
The bill’s introduction has already rattled the stock market. Shares of companies owning PBMs, such as CVS Health, Cigna, and UnitedHealth Group, fell between 4.8 percent and 5.5 percent following the news, according to CNBC.
Despite the market reaction, some analysts remain skeptical about the bill’s prospects. Chris Meekins of Raymond James assigned it less than a five percent chance of passing in the next two years, citing political dynamics and the timing within the current congressional session.
The legislation also has a companion bill in the House, sponsored by Representatives Diana Harshbarger (R-Tenn.) and Jake Auchincloss (D-Mass.), indicating a concerted effort across both chambers to address PBM practices.
This move aligns with ongoing scrutiny from the Federal Trade Commission, which has been investigating PBMs for market manipulation and price inflation, particularly concerning insulin.
Despite uncertainty, the bill highlights a bipartisan push to address issues in the pharmaceutical supply chain. Whether it succeeds or not, it signals growing scrutiny of PBMs and their influence. For patients and small pharmacies, this fight is far from over. But for Wall Street, it is already making waves.
