Harshbarger, Colleagues Renew Bipartisan Push to Put Patients Before Monopolies, Cut Drug Costs

Washington, D.C. - Congresswoman Diana Harshbarger (R-TN) and Congressman Jake Auchincloss (D-MA) today reintroduced the Patients Before Monopolies (PBM) Act with expanded bipartisan support. The legislation would prohibit the joint ownership of Pharmacy Benefit Managers (PBMs) and pharmacies-a glaring conflict of interest that has allowed these shadowy middlemen to manipulate the system, pad their own pockets, and squeeze patients and independent community pharmacies dry in the process.

The Senate version of the bill was introduced by Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) alongside Senators Roger Marshall (R-KS) and John Fetterman (D-PA).

"As a lifelong pharmacist, I've seen firsthand how PBMs game the system. When the same corporate giant that sets reimbursement rates also owns the pharmacy collecting them, that's not a free market-it's a rigged one," said Congresswoman Diana Harshbarger . "We have antitrust laws for a reason. When monopolies squeeze out independent pharmacies, raise costs for patients, and reduce consumer choice, Congress has a duty to restore fair competition. The Patients Before Monopolies Act ends this blatant conflict of interest once and for all."

"Like so many small business owners in America, independent pharmacists are working hard and playing by the rules but getting ripped off by monopolies. The PBM industry is rife with self-dealing and price gouging. Congress made modest but meaningful reforms earlier this year, and now the next step is banning PBMs from owning pharmacies. It's an unacceptable conflict of interest and yet another example of the vertical integration in health care that is raising prices for patients," said Congressman Jake Auchincloss .

"Pharmacy Benefit Managers (PBMs) have been stealing hope and health from the American people for decades, inflating prescription drug costs, forcing pharmacy closures, and blocking access to medications." As a pharmacist from coastal Georgia, I came to Congress with the goal of building a health care system that puts patients before profits," said Congressman Buddy Carter. "I proudly support the Patients Before Monopolies Act, which builds on my previous PBM legislation signed into law last January, to continue cracking down on PBMs' anti-competitive practices."

"Americans are sick and tired of giant corporations putting profits over patients," said Congressman Troy Nehls. "For too long, the largest Pharmacy Benefit Managers (PBMs) have manipulated the prescription drug market supply chain, crushed independent pharmacies, and have driven up costs for patients. I'm proud to be an original cosponsor on this bipartisan legislation to restore accountability, protect local pharmacies, and lower costs for American families."

"We're taking on these giant healthcare companies to get prescription drug prices down, and to protect our family-owned pharmacies. These companies make billions in part because they control so much of the market, but our bill will change that and put patients first," said Congressman Greg Landsman.

"Pharmacy Benefit Managers drive prices up for patients and run independent pharmacies out of business. These greedy corporations have dodged regulation at the cost of American patients and small businesses for far too long. For my entire career, I have fought to make healthcare accessible for all Americans, and I am proud to support this bill reining in PBMs and enforcing fair business practices," said Congressman Jerry Nadler.

"Our PBM Act is gaining momentum because people are realizing that you can't lower health care costs without tackling corporate greed in the health care system," said Senator Elizabeth Warren. "It's time we finally rein in the health care middlemen that are jacking up drug costs and driving small pharmacies out of business."

"Americans are paying more and more for healthcare while seeing less in return. PBMs are at the center of a broken system that rewards middlemen while driving up costs for patients and pushing out independent pharmacies," said Senator Josh Hawley . "Working Americans deserve better. This legislation is a major step toward restoring transparency and making healthcare more affordable for every American."

Since this bill was first introduced in 2024, states across the country have sought to break up these giant conglomerates:

• In early 2025, Arkansas passed a law to prevent the joint ownership of PBMs and pharmacies.
• Later that year, 39 state attorneys general wrote a letter urging Congress to "pass[] an act prohibiting PBMs, their parent companies, or affiliates from owning or operating pharmacies."
• In April, Tennessee lawmakers passed a law to ban joint ownership of PBMs and pharmacies, and the Tennessee Governor is expected to sign the bill into law as soon as this week.

This growing bipartisan momentum in support of the goals of the PBM Act from across the nation sends an important signal to Congress that the work to rein in PBMs is not yet finished.

In the 119th Congress, new cosponsors include Congressmen Buddy Carter (R-GA) and Greg Landsman (D-OH) of the House Energy and Commerce Committee, and Jerry Nadler (D-NY) and Troy Nehls (R-TX) of the House Judiciary Committee. Notably, the PBM Act would be considered by the House Energy and Commerce Committee or the Judiciary Committee before reaching the House Floor under regular order. New cosponsors in the Senate include Senators Roger Marshall (R-KS) and John Fetterman (D-PA).

Over the past decade, pharmacy benefit managers (PBMs)-the middlemen between pharmacies and insurance companies-have morphed into large health care conglomerates that exercise control over nearly every link in the prescription drug coverage and delivery chain. Today, the largest healthcare conglomerates each own a PBM-which pay for pharmacy services-as well as the pharmacy chains that provide those services. This inherent conflict of interest results in higher drug costs for patients and fewer independent pharmacies, but bigger profits for the corporate healthcare giants.

The Patients Before Monopolies (PBM) Act would address this by:

• Prohibiting a parent company of a PBM or an insurer from owning a pharmacy business.
• Requiring that a parent company in violation of the PBM Act divest its pharmacy business within one year.
• Enabling the Federal Trade Commission (FTC), Department of Health and Human Services (HHS), Department of Justice (DOJ), state attorneys general, and harmed individuals to enforce the law against violators by requiring them to divest their pharmacy business and disgorge any revenue received during the period of such violation.
• Directing the FTC to distribute any disgorged revenue to harmed communities, including consumers overcharged at vertically integrated pharmacies.
• Authorizing the FTC and DOJ to monitor pharmacy business divestment, and impose monetary penalties if companies drag their feet or fail to comply.
• Mandating reporting of all divestitures to the FTC, and allowing the FTC to review all divestitures and subsequent acquisitions to protect competition, financial viability, and the public interest.

The Patients Before Monopolies (PBM) Act is endorsed by American Pharmacy Cooperative, Inc. (APCI), National Community Pharmacists Association (NCPA), Pharmacists United for Truth and Transparency (PUTT), Patients Rising, Coalition of State Rheumatology Organizations (CSRO), Alliance for Transparent and Affordable Prescriptions (ATAP), American Pharmacies, and American Economic Liberties Project (AELP).

CLICK HERE to read what they're saying about the PBM Act .

CLICK HERE for a one-pager on the bill.

CLICK HERE for a section-by-section summary.

CLICK HERE for the full text of the bill.

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