House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) today is launching an investigation into pharmacy benefit managers’ (PBM) tactics that are harming patient care and increasing costs for consumers. Chairman Comer is calling on senior officials at the Office of Personnel Management (OPM), Centers for Medicare and Medicaid Services (CMS), and the Defense Health Agency (DHA) for documents and communications to determine the extent PBMs’ tactics impact healthcare programs administered by the federal government. Additionally, Chairman Comer is calling on the largest PBMs—CVS Caremark, Express Scripts, and OptumRx—to provide documents, communications, and information related to their practices that are distorting the pharmaceutical market and limiting high quality care for patients.
“Pharmacy Benefit Managers’ anticompetitive tactics are driving up health care costs for Americans and harming patient care. Federal agencies administering health care programs for seniors, active-duty military, and federal employees rely on PBMs as middlemen to set drug prices, which opens the door to government waste at the expense of American taxpayers. Greater transparency in the PBM industry is vital to determine the impact that their tactics are having on patients, the pharmaceutical market, and health care programs administered by the federal government. The House Oversight and Accountability Committee is shining a light on this issue in the healthcare system and will continue to examine solutions to make prescription drugs more affordable for all Americans,” said Chairman Comer.
CVS Health’s CVS Caremark, Cigna’s Express Scripts, and United Health Group’s Optum Rx control an estimated 80 percent of the PBM marketplace. In Committee Republicans’ December 2021 report, initial findings revealed that large PBM consolidation has negatively impacted patient health, increased costs for consumers, forced manufacturers to raise their prices, and created conflicts of interest which distort the market and limit high quality care for patients.
Below are the letters Chairman Comer sent today:
Office of Personnel Management
Centers for Medicare and Medicaid Services
Defense Health Agency