At a recent press conference at Mar-a-Lago, President-elect Donald Trump made a bold promise to take on the powerful Pharmacy Benefit Managers (PBMs) responsible for inflating prescription drug prices in the U.S. Trump criticized PBMs, calling them a “horrible middleman” that profits by driving up drug costs without adding value. He vowed to eliminate the middleman and reduce drug prices to levels “that nobody has ever seen before.”
Trump discussed his administration’s commitment to reforming the PBM system, highlighting ongoing discussions with Health and Human Services nominee Robert F. Kennedy Jr. and Center for Medicare and Medicaid Services nominee Dr. Mehmet Oz. “We spent more time talking about that than anything else,” Trump noted, emphasizing the importance of addressing PBM-driven cost inflation.
PBMs, such as CVS Caremark, Express Scripts, and OptumRx, dominate the market, managing drug benefits for over 270 million Americans and controlling about 80% of the PBM industry. Critics argue that PBMs drive up costs by pushing more expensive drugs onto patients and doctors, prioritizing profit over patient care. Pharmacist Kevin Duane from Jacksonville, Florida, testified before the House Committee on Oversight and Accountability, explaining that PBMs dictate which medications are used based not on quality but on their potential to generate profits.
In 2020, Trump introduced a policy aimed at helping seniors by ensuring they directly benefit from the rebates paid by drug manufacturers to PBMs. These rebates were designed to lower drug costs for seniors, but President Biden repealed the rule through the Inflation Reduction Act, preventing these savings from reaching those most in need.
Trump’s team plans to reinstate the Trump Rebate Rule and work with Congress to pass key bills like The Modernizing and Ensuring PBM Accountability Act (S. 2973) and the Mental Health, Lower-Cost Drug and Extenders Package (S. 3430). These legislative efforts aim to break the link between PBM fees and drug prices, ensuring that savings go directly to patients, particularly seniors.
By eliminating PBM middlemen and fixing the system, Trump hopes to deliver significant savings to America’s seniors and kick-start his healthcare agenda.
