Axios Pro Exclusive Content

Senate Commerce approves PBM transparency bill

Mar 22, 2023
Senators Maria Cantwell and Ted Cruz at a Commerce Committee hearing

Cantwell and Cruz at a Commerce Committee meeting March 1. Photo: Anna Moneymaker/Getty Images

The Senate Commerce Committee approved the bipartisan Pharmacy Benefit Manager Transparency Act Wednesday on an 18-9 vote.

Why it matters: The bill, sponsored by Sens. Maria Cantwell and Chuck Grassley, won the support of five other Republicans — suggesting it would garner some GOP support if it gets a vote in the full Senate.

Between the lines: The committee Republicans who voted for the bill were Sens. Deb Fischer, Jerry Moran, Dan Sullivan, J.D. Vance and Shelley Moore Capito.

  • Sen. Kyrsten Sinema, now an Independent who caucuses with Democrats, joined the remainder of Republicans in voting no.

How it works: The bill would prohibit PBMs from participating in a practice called "spread pricing" and from clawing back reimbursements. It also would require PBMs to report transparency information to the Federal Trade Commission.

  • Sen. Ted Cruz, the ranking Republican on the committee, offered several amendments focused on ensuring that the legislation wouldn't give the FTC expanded authority and also that smaller PBMs wouldn't be affected by the bill. All of his amendments were voted down.

The other side: “Today’s vote in the Senate Commerce Committee is a clear indication that S. 127 is contentious legislation that would expand the authority and jurisdiction of the Federal Trade Commission," PCMA, the PBM trade lobby group, said in a statement after the markup.

  • "In addition, the legislation risks increasing prescription drug costs and would take away employers’ choice and flexibility in designing pharmacy benefits that best fit the needs of their enrollees."

What we're watching: The same bill previously passed out of the Senate Commerce Committee last year, 19-9, but was never put on the Senate floor for a full vote.

  • While there does seem to be momentum for PBM reform in this Congress, it remains to be seen whether this particular bill will see any further action.
Go deeper