TAPP Urges Lawmakers to Support PBM Reforms

On Thursday, July 24, the Justice Department’s Antitrust Division and the Federal Trade Commission, along with the Department of Commerce and the Department of Health and Human Services, hosted their second of three listening sessions as part of implementing President Trump’s Executive Order No. 14273, Lowering Drug Prices by Once Again Putting Americans First.

While the panel covered several topics, such as practices and regulation that harm competition, anticompetitive concerns from Orange Book listings, and litigation issues, one almost unanimous message rang clear — increased transparency within the market, especially among PBM transactions, is critical in order to realign incentives around patients, not profits. 

TAPP echoes this sentiment and recommends the following PBM reforms to inject transparency and competition into a system that has become increasingly consolidated and opaque:

  • Align PBM Fees with Services, Not Drug Prices

Today, PBMs often profit more when drug prices are higher — a backwards incentive. Restructuring PBM compensation so it’s based on the services they actually deliver, like negotiating discounts, rather than on the price of the medicine itself would shift the focus back to cost savings for patients.

  • Tackle Anti-Competitive Practices from Vertical Integration

The seminar highlighted how vertical integration among insurers, PBMs, and pharmacies distorts competition. TAPP supports reforms that prevent PBMs from steering patients toward their own high-cost, in-network pharmacies, or favoring drugs that maximize profits over affordability. 

  • Fix Cost-Sharing Assistance Schemes

PBM practices often limit the impact of manufacturer copay assistance, leaving patients to pay more out-of-pocket. Reforms are necessary to end these loopholes so patients truly benefit from savings programs rather than letting PBMs and insurers pad their bottom line.

These reforms reflect what today’s experts made clear: lowering drug prices is possible if we restore competition, prioritize patients, and demand accountability from the industry’s most powerful actors. As Congress considers reforming PBM legislation, TAPP urges the Trump administration to seize this opportunity to protect patients and strengthen America’s leadership in healthcare innovation.

Ainsley Shea