Congress is coming to a drama-filled ending, just like it started.

In a session marked by impeachment investigations and booting the Speaker, it is now coming down the wire on a key package that includes PBM reform. The PBMs, Pharmacy Benefits Managers, have become a target of Republicans and Democrats over the last few years, with lawmakers on both sides accusing them of being the middlemen who drive up the prices. Now, allies of the President-elect have pointed out that the PBMs are lobbying against his agenda.

A source close to the Trump policy team tells BizPac, “The PBMs are in for a rude awakening. We know they are spreading disinformation to Capitol Hill. President Trump has made it clear: the PBMs must be held accountable for driving up prices on the average American. Congress should do this now so the Trump Admin can do more later.”

State of Play on Capitol Hill:

We are hearing from sources on Capitol Hill that the PBMs and their insurer parents blanketed the Hill with broad claims about a “Big Pharma” bailout in the end-of-year funding agreement.

One senior House Republican Leadership aide told this outlet, “The PBMs are shameful and lying to staffers about this package. We are not dumb. PBMs have been the driving force on raising drug prices on the middle class. Republicans know this.”

However, an investigation into the package shows that is not true. The reality is that the package includes $3 Billion in cuts from the pharmaceutical industry, including long-opposed reforms to the patent system to end so-called “patent thickets.” Despite PBM claims, the package is, in fact, balanced with roughly equal savings from Pharma, PBMs, and hospitals. PBMs, however, are used to operating in anonymity to maximize profits and are doing everything they can to undermine the package. They are also extremely powerful following a decade-and-a-half of horizontal and vertical integration fueled by Obamacare.

When asked about PBM reform, the powerful chairman of the House GOP Oversight Committee James Comer stated: “President Trump is absolutely right about Pharmacy Benefit Managers and how they’ve driven up the price of lifesaving drugs for all Americans. My Oversight Committee Investigation exposed how PBMs operate in the dark and abuse their position to line their own pockets. Time for reform.”

Trump Factor:

In a recent NBC interview when talking about PBM reform and healthcare, President Trump stated, “The middlemen make more money than the drug companies. There is a middleman that no one knows even who they are. If you look at our drug prices, they are much higher.”

Sounds like Trump has some unfinished business on drugmaker rebates and PBMs pic.twitter.com/A2ohGGI8G3

— Antonio Ciaccia (@A_Ciaccia) December 9, 2024

Sources involved in the process tell us that the PBM opposition is focused on scaring conservatives despite the fact that the package is an important first step in what Trump himself has said is a priority to save patients money by bringing more accountability to the middleman.

Trump’s incoming HHS Secretary Robert F. Kennedy Jr. has also made reforming the PBMs a top priority of his agenda. Overall, our reporting finds that the healthcare package as a whole is a big win for Republicans since many expiring healthcare programs would otherwise have to be funded in March, which would give significant leverage to Democrats seeking to undermine Trump’s promised tax cuts.

One thing is clear from our reporting: President Trump supports reforming PBMs.