#pharmacy-benefit-managers

#pharmacy-benefit-managers

Pharmacy benefit managers (PBMs) are opaque intermediaries-and they are unpopular with figures including Mark Cuban, who told Fortune that the way they bargain over drug prices is absurd, something that would never happen at the very same pharmacies buying a package of Pringles potato-chip products.

For years, Congress has signaled that it wants to crack down on Pharmacy Benefit Managers, the middle men that have come under fire for their vertical integration with insurers and their role in spiking drug costs. This week, it finally happened via the Consolidated Appropriations Act of 2026, promptingemployer groups including the Purchaser Business Group on Health (PBGH) and the ERISA Industry Committee to cheer its passage.

It would expand association health plans, which allow small businesses to band together and purchase coverage, impose new transparency requirements on pharmacy benefit managers aimed at lowering drug costs, and fund ACA payments known as cost-sharing reductions. The Senate, which gridlocked on an ACA subsidy extension and competing GOP plan, isn't expected to take up the House package. But some of the ideas could resurface in late January, when Congress faces another deadline to keep the government funded.

He said that the administration has "some great people working on this project," but he would "give the program, and what we know, as of today, a grade of B." "Why not an A? The stock prices of PBMs didn't get crushed," wrote Cuban. "Which means, so far, no one expects much change for them. Which they expect they will make up lost revenues from patients, companies, and other payers elsewhere."