RICHMOND (CVILLE RIGHT NOW) – State Attorney General Jason Miyares has joined 38 other attorneys general sending a letter to congressional leadership urging passage of an act that would prohibit pharmacy benefit managers, or PBMs, from owning or operating pharmacies. According to a 2023 Journal of the American Medical Association article providing an overview of the industry, “Pharmacy benefit managers (PBMs) play a major role in the provision of pharmacy services by acting as intermediaries between pharmacies, plan sponsors (insurance companies and employers), pharmaceutical manufacturers, and drug wholesalers. As their role and visibility have increased, PBMs have come under increased scrutiny from policymakers. However, no prior literature has systematically described the history, business practices, and policymaking of PBMs.” Click here for the complete abstract.

A Virginia Attorney General’s office release claims “over the past few decades, horizontal consolidation and vertical integration have transformed PBMs from useful administrative service providers into market-dominating behemoths that control the industry. Each of the top six PBMs operate their own affiliated pharmacies, while five of the top six are also a part of parent conglomerates that operate insurance companies and health care clinics. PBMs—through ownership of affiliated pharmacies—are contracting with and have power over their own pharmacies’ competition. The PBMs then use their place as middlemen to exert this power in ways that harm independent pharmacies, forcing these small businesses to accept contractual terms that are confusing, unfair, arbitrary, and harmful.”

“PBMs were originally created to streamline prescription drug access and reduce costs for patients, but they’ve become powerful gatekeepers, operating without transparency or accountability. When the same companies that negotiate drug prices also own the pharmacies dispensing those drugs, it creates a clear conflict of interest—one that exploits consumers and jeopardizes independent pharmacies,” said Attorney General Jason Miyares. “It’s time for Congress to help restore balance to the prescription drug marketplace. Virginians, and Americans, deserve better, and I’m fighting to ensure they get it.”
Click here for the entire release, including a link to the letter.