Is Pharmacy Benefit Manager Reform in Danger?

PBM Reform at a frustrating standoff despite overwhelming support.

Pharmacists and pharmacy owners are all too familiar with the challenges posed by Pharmacy Benefit Managers (PBMs) and their impact on the ability to serve your communities and maintain sustainable businesses. The fight for meaningful PBM reform has seen both progress and frustrating setbacks.

A significant development has been the introduction of the Protecting Pharmacies in Medicaid Act. This bipartisan bill, led by Senators Peter Welch (D-Vt.), Roger Marshall (R-Kan.), Mark Warner (D-Va.), and Bill Cassidy (R-La.), directly targets abusive pricing practices, specifically "spread pricing." Spread pricing occurs when PBMs charge Medicaid more for a drug than they reimburse the dispensing pharmacy, allowing the PBMs to pocket the difference.

This practice has been identified as a major contributor to the financial struggles and…