WASHINGTON – Sen. Chuck Grassley (R-Iowa), Chairman of the Senate Judiciary Committee and former Chairman of the Senate Finance Committee, and Sen. Maria Cantwell (D-Wash.), Ranking Member of the Senate Commerce Committee, are reintroducing two bipartisan bills to combat the high cost of prescription drugs and provide greater transparency of pharmacy benefit managers (PBMs).
“Iowans are fed up with the skyrocketing cost of prescription drugs and eager for Congress to act to put a stop to pharmacy benefit managers’ shady practices. These bipartisan legislative solutions will bring much-needed transparency to prescription drug pricing and ensure the federal government can effectively target the abusive practices that unfairly drive up drug costs,” Grassley said.
“For too long, Americans have been left in the dark while PBMs – the mysterious middlemen – manipulate prescription drug prices. We need to hold PBMs accountable for skyrocketing drug costs. With these bipartisan bills, I’m continuing to fight for accountability and transparency in the drug market so we can shine a light on unfair practices and make sure patients get a fair deal on the medications they need,” Cantwell said.
Prescription Pricing for the People Act:
This bill requires the Federal Trade Commission (FTC) to complete a 6(b) study examining the effects of consolidation on pricing in the PBM industry, as well as other potentially abusive behavior by PBMs. The bill instructs the FTC to provide policy recommendations to Congress to improve competition and protect consumers.
Grassley has welcomed the FTC's interim staff reports on opaque PBM practices. The interim staff reports are a direct result of Grassley’s prior requests for a 6(b) study on potential anti-competitive practices in the prescription drug industry, as well as his bipartisan demands for a status update in light of FTC’s significant delays. Once passed, this legislation will bring the FTC 6(b) study to completion. The bill falls within the jurisdiction of the Senate Judiciary Committee.
Additional cosponsors are Sens. Roger Marshall (R-Kan.), Peter Welch (D-Vt.), Tommy Tuberville (R-Ala.), Chris Coons (D-Del.), Thom Tillis (R-N.C.), Richard Blumenthal (D-Conn.), Shelley Moore Capito (R-W.Va.), Mazie Hirono (D-Hawaii) and James Lankford (R-Okla.).
The bipartisan proposal is supported by the AARP, AIDS Healthcare Foundation, American Pharmacists Association, Biotechnology Innovation Organization, Community Oncology Alliance, National Community Pharmacists Association and National Association of Specialty Pharmacy.
Pharmacy Benefit Manager (PBM) Transparency Act:
This bill bans deceptive and unfair pricing schemes, prohibits arbitrary claw backs of payments made to pharmacies, and requires PBMs to report to the FTC on how much money they make through spread pricing and pharmacy fees. The bill falls within the jurisdiction of the Senate Commerce Committee.
Additional cosponsors are Sens. Joni Ernst (R-Iowa), Peter Welch (D-Vt.), Shelley Moore Capito (R-W.Va.), Jeanne Shaheen (D-N.H.), Roger Marshall (R-Kan.), Martin Heinrich (D-N.M.), Jerry Moran (R-Kan.), Cindy Hyde-Smith (R-Miss.), Thom Tillis (R-N.C.) and Mike Rounds (R-S.D.).
The bipartisan proposal is supported by the AARP, AIDS Healthcare Foundation, American Pharmacists Association, Association for Clinical Oncology, Association of Mature American Citizens, Autoimmune Association, Biotechnology Innovation Organization, Crohn’s & Colitis Foundation, Community Oncology Alliance, National Community Pharmacists Association and National Association of Specialty Pharmacy.
“AARP, which advocates for the more than 100 million Americans aged 50 and over, is pleased to support the Prescription Pricing for the People Act of 2025 and Pharmacy Benefit Manager (PBM) Transparency Act of 2025. We value your ongoing bipartisan efforts to lower drug prices for consumers and taxpayers. It is outrageous that Americans pay the highest prices in the world for prescription drugs,” said Bill Sweeney, Senior Vice President, Government Affairs, AARP.
“APhA supports Senators Grassley’s and Cantwell’s reintroduction of the Pharmacy Benefit Manager Transparency Act, which would go a long way toward addressing PBMs’ anticompetitive business practices putting many independent pharmacies out of business and creating ‘pharmacy deserts’ in rural and underserved communities, where the neighborhood pharmacy may be the only health care provider for miles. We also support the Prescription Pricing for the People Act directing the FTC to report on ways to enforce antitrust and consumer protection laws. APhA stands ready to work with Senators Grassley and Cantwell and the FTC to not only examine PBMs’ anticompetitive business practices but to take the necessary actions to end them,” said the American Pharmacists Association.
“The Community Oncology Alliance (COA) commends Senators Grassley and Cantwell for once again taking an early lead in introducing pharmacy benefit manager (PBM) legislation in the 119th Congress. The Prescription Pricing for the People Act (S.113 in the 118th Congress) and the Pharmacy Benefit Manager (PBM) Transparency Act (S.127 in the 118th Congress) lit the fuse for additional legislation in both the Senate and the House to stop the top PBMs from harming patients, especially those with cancer. We thank Senators Grassley and Cantwell for their leadership in reintroducing these bills in the 119th Congress. Americans face medication delays and denials, as well as higher costs and waste, at the hands of the top PBMs, especially CVS/Caremark, Cigna/Express Scripts, and United/Optum Rx, which control 80 percent of the prescription drug market. They have to be stopped from harming cancer patients and others with serious diseases. It’s time for Congress to act now!” said Ted Okon, Executive Director, Community Oncology Alliance (COA).
“Increased transparency into PBM operations is critical to understanding the many ways their underhanded tactics lead to increased costs, delayed access to care, and an unfair marketplace for independent pharmacies – tactics that need swift, significant reforms. The PBMs’ attempt to block every action to increase transparency in the drug delivery system should concern everyone from patients to policymakers. We’re grateful to our allies in Congress like Sens. Grassley and Cantwell for keeping these bills on their agenda and pushing for accountability and change. PBM reform cannot wait,” said B. Douglas Hoey, CEO, National Community Pharmacists Association.
“IBD patients deserve to understand why PBMs are making the decisions that they do, and whether these decisions are financially motivated or based on science. They should also share in any cost savings achieved by PBMs. The Pharmacy Benefit Manager Transparency Act would make great strides in revealing the true motives and operating practices of PBMs, and in aligning their incentives with increased patient access to medications,” said Erin McKeon, Director, Federal Advocacy, Crohn's & Colitis Foundation.
“The Pharmacy Benefit Manager Transparency Act of 2025 would prevent anti-competitive practices and require PBMs to operate with full transparency. This bill ensures that PBMs can no longer manipulate pricing, prioritize profits over patients, or exploit loopholes that drive up costs. AMAC Action is committed to protecting seniors from predatory pricing schemes and ensuring they have access to affordable prescription medications. We commend you both for leading this bipartisan effort and urge Congress to swiftly pass this legislation to bring long-overdue transparency and accountability to the PBM industry,” said Andrew J. Mangione Jr., Senior Vice President, AMAC Action.
“We appreciate Senator Grassley and Senator Cantwell’s unwavering leadership in addressing harmful PBM pricing practices. As we have previously said, these bills take critical steps toward curbing predatory PBM practices that drive up prescription drug costs for patients, employers and unions. Late last year, Congress had the opportunity to take meaningful action on PBM reform but failed to get it done. Now, early this year, it is more urgent than ever for Congress to make PBM reform a top priority and finally deliver the transparency and accountability that Americans deserve. These bills will expose hidden PBM profit schemes, eliminate harmful practices like spread pricing and reimbursement clawbacks, and provide much-needed oversight of the largest PBMs that control over 80% of drug purchasing. The time for action is now—Congress must act swiftly to rein in PBMs and restore fairness to the prescription drug marketplace," said Mark Blum, Managing Director of the PBM Accountability Project.
About Pharmacy Benefit Managers
PBMs were initially formed in the 1960s to process claims and negotiate lower drug prices with drug makers. Now, PBMs administer prescription drug plans for hundreds of millions of Americans.
Today, three PBMs control nearly 80 percent of the prescription drug market. They serve as middlemen, managing every aspect of the prescription drug benefits process for health insurance companies, self-insured employers, unions and government programs.
They operate out of the view of regulators and consumers — setting prescription costs, deciding what drugs are covered by insurance plans and how they are dispensed, pocketing unknown sums that might otherwise be passed along as savings to consumers, and undercutting local independent pharmacies.
This lack of transparency makes it impossible to fully understand if and how PBMs might be manipulating the prescription drug market to increase profits and drive-up drug costs for consumers.
Background:
Grassley has long championed efforts to reduce the cost of prescription drugs. Three pieces of legislation authored and coauthored by Grassley have been signed into law to combat anticompetitive practices and stop drug makers from reaping profits at the expense of taxpayers and consumers. Grassley has also led in-depth congressional investigations to expose those responsible for prescription drug price gouging.
Other actions include:
Learn more about Grassley’s persistent efforts to lower prescription drug costs HERE.