{"database": "press", "table": "releases", "rows": [["https://comer.house.gov/2023/9/comer-pharmacy-benefit-managers-deploy-drug-pricing-tactics-to-line-their-own-pockets", "Comer: Pharmacy Benefit Managers Deploy Drug Pricing Tactics to Line Their Own Pockets", "2023-09-19", "2023", "2023-09", "Republican", "House", "KY", "James Comer", "C001108", "comer.house.gov", "comer", "https://comer.house.gov/media", "scraper", "FOR IMMEDIATE RELEASE\n\nContact:Austin Hacker\n\nWASHINGTON \u2013 Today, House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) delivered opening remarks at a full committee hearing titled \u201cThe Role of Pharmacy Benefit Managers in Prescription Drug Markets Part II: Not What the Doctor Ordered.\u201d In his opening statement, Chairman Comer noted that this is the committee\u2019s second hearing on PBMs and emphasized that their tactics are causing Americans to suffer from rising health care premiums and expensive prescription drug prices. He described how these deliberate, anticompetitive pricing tactics aim to prevent payers\u2014including government payers like Medicare, Medicaid, Tricare, and the Federal Employee Health Benefits program\u2014from understanding how PBMs are making billions at the expense of patients and taxpayers. Three large PBMs have now monopolized the pharmaceutical market and engage in these self-benefitting practices that boost their bottom line without a benefit to patients. He stressed that greater transparency and accountability is needed in the PBM industry. In addition to the PBM Committee report released in 2021, Chairman Comer concluded that the Committee will continue to press forward to shine a light on PBMs undermining health practices and work to inform legislative solutions.\n\nBelow are Chairman Comer\u2019s remarks as prepared for delivery.\n\nI want to welcome everyone to today\u2019s hearing on the role of Pharmacy Benefit Managers in Pharmaceutical Markets.\n\nThis is the second hearing in our series discussing pharmacy benefit managers, or PBMs, and their role in the pharmaceutical market.\n\nLast Congress, Oversight Republicans conducted a review of PBMs.\n\nWhat we found was deeply concerning and raised many questions about PBMs\u2019 role in the healthcare industry.\n\nPBMs started out as beneficial additions to the healthcare system because they were competing with each other to provide clarity to pharmacies, payers, and patients about drug costs.\n\nBut that environment of competition and transparency is no longer true today.\n\nInstead of fierce competition, now just three PBMs control 80 percent of the market.\n\nAnd each of the three major PBMs\u2014CVS Caremark, Express Scripts, and Optum Rx\u2014is owned by a major health insurer and owns, or is owned, by a pharmacy.\n\nThis means that when PBMs negotiate with a pharmacy or a health insurer, they are either negotiating with themselves or one of their direct competitors.\n\nThis can create incentives to do things that have negative impacts on patients.\n\nThat is why the Committee\u2019s examination of PBMs is a priority this Congress.\n\nOur concerns were compounded by what we learned in our first PBM hearing, held earlier this year in the spring.\n\nWe heard from Greg Baker, a pharmacist in Jacksonville, Florida, who discussed how he is unable to serve Tricare beneficiaries in his community.\n\nThis is because Express Scripts is forcing Tricare beneficiaries to use specific pharmacies on military bases.\n\nWe heard from Dr. Miriam Atkins, an oncologist in Georgia, who discussed how PBMs\u2014not doctors\u2014can dictate which drugs a patient can use.\n\nThey do this through tactics that require a patient to fail on a certain drug before trying another drug, and by requiring the use of mail order pharmacies, which can be unreliable and wasteful.\n\nWe also heard from Greg Baker, the CEO of AffirmedRx, a transparent PBM that works to provide clear pharmacy benefit services to employers.\n\nHe discussed how typical PBM practices could be considered price gouging and gave examples of a cancer drug, Imatinib, and the difference in price for a 30-day supply of Imatinib at Cost Plus Drugs versus CVS.\n\nThat difference is astounding.\n\nA 30-day supply at Cost Plus Drugs costs $72.\n\nThat very same 30-day supply at CVS costs more than $17,000.\n\nThose two prices are for the exact same prescription.\n\nIt begs the question, why is one prescription so much more expensive? And what is happening with that extra money?\n\nWe know that PBMs regularly engage in spread pricing, where PBMs overcharge payers and underpay pharmacies, and pocket the extra money.\n\nWe also know that drug manufacturers pay rebates to PBMs in order to be placed in a favorable tier on a formulary, which can make it difficult for competing prescriptions\u2014often generics or biosimilars\u2014to get on formularies.\n\nThese practices have real world consequences, and impact constituents in all our districts.\n\nI hope today\u2019s hearing provides more clarity into the pharmaceutical market so that Congress can determine what actions are necessary.\n\nI thank the witnesses, and now yield 5 minutes to Ranking Member Raskin for his opening statement.\n\n###", 1, "2026-03-30T01:40:41Z", "2026-04-08T00:37:48Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://comer.house.gov/2023/9/comer-pharmacy-benefit-managers-deploy-drug-pricing-tactics-to-line-their-own-pockets"], "units": {}, "query_ms": 0.8265508804470301, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}