FOR IMMEDIATE RELEASE
CONTACT: media@naag.org
April 14, 2025
Washington, D.C.— Today the National Association of Attorneys General, on behalf of a bipartisan coalition of 39 state and territory attorneys general, sent a letter to congressional leaders urging them to pass an act prohibiting pharmacy benefit managers (PBMs) from owning or operating pharmacies.
Pharmacy Benefit Managers (PBMs) serve as third-party administrators for prescription drug programs within health plans. Over the years, both horizontal consolidation and vertical integration have shifted PBMs from being helpful administrative service providers to market-dominating giants that control the industry. Each of the six largest PBMs has its own affiliated pharmacies, and five of these major players are also associated with parent companies that manage insurance firms and healthcare clinics.
By owning affiliated pharmacies, PBMs exert influence over their competitors, using their intermediary role to impose conditions that disadvantage independent pharmacies. This often forces these small businesses to accept complex, unjust, arbitrary, and detrimental contractual agreements.
In a recent letter to Congress, this bipartisan coalition highlighted the significant impact of PBMs on the healthcare market. They stated, “PBMs have overtaken the market and now wield outsized power to reap massive profits at the expense of consumers. The rise of PBMs as middlemen in the prescription drug market has resulted in patients facing fewer choices, lower quality care, and higher prices”.1
The letter further emphasized the need for legislative action, noting, “Congressional action is warranted to restore a free market and protect consumers and small businesses. As self-designated middlemen, PBMs should not be permitted to own or operate affiliated pharmacies”.1
The passage of such a law would foster competition in the marketplace and give consumers more access to pharmaceutical care, more choice as to their healthcare providers, and more affordable prices.
The letter, sponsored by the attorneys general of Arkansas, Massachusetts, Missouri and Vermont, was also signed by Alaska, American Samoa, Arizona, California, Delaware, District of Columbia, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Virgin Islands, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
To read the letter, click here.
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The National Association of Attorneys General is a nonpartisan organization of the attorneys general of the 50 states, the District of Columbia, and U.S. territories. NAAG provides a forum for the exchange of knowledge, experiences, and insights on legal and law enforcement issues, and fosters bipartisan collaboration among its members to address common challenges and advance the rule of law. For more information, please visit NAAG’s website.
