AMAC Supports Bill to Investigate PBMs Business Practices

This legislation instructs the Federal Trade Commission (FTC) to thoroughly investigate the business practices of pharmacy benefit managers (PBM)—a necessary step toward ensuring fair pricing and transparency in the prescription drug market.

February 6, 2025

The Honorable Chuck Grassley
United States Senator for Iowa
135 Hart Senate Office Building
Washington, DC 20510

The Honorable Maria Cantwell
United States Senator for Washington
511 Hart Senate Office Building
Washington, DC 20510

Dear Senators Grassley and Cantwell,

On behalf of AMAC Action, the advocacy affiliate of AMAC – the Association of Mature American Citizens, and our more than 2 million members, I write to express our strong support for the Prescription Pricing for the People Act of 2025. This legislation instructs the Federal Trade Commission (FTC) to thoroughly investigate the business practices of pharmacy benefit managers (PBM)—a necessary step toward ensuring fair pricing and transparency in the prescription drug market.

As an organization representing millions of older Americans, many living on fixed incomes, we are deeply concerned that PBM anti competitive practices continue to drive up drug costs. AMAC Action has been a leader in urging Congress and the FTC to shine a light on these harmful business practices, and we greatly appreciate your commitment to holding PBMs accountable and protecting consumers. PBMs were originally designed to negotiate lower drug prices, yet over time, these middlemen have prioritized profit over patients, leading to higher prescription drug costs and reduced competition. AMAC has been vocal in highlighting how PBMs engage in practices that are not in the best interest of consumers or independent pharmacies. One of the most troubling issues is spread pricing, where PBMs charge insurance providers, including Medicare and Medicaid, a significantly higher price for prescription drugs than they reimburse pharmacies. This practice allows PBMs to pocket the difference, inflating costs for taxpayers and consumers without delivering any added value.

PBMs have also been found to steer patients toward their own affiliated or corporate-owned pharmacies, reducing consumer choice and creating monopolistic control over drug distribution. Instead of allowing patients to select the pharmacy that best meets their needs, PBMs push them toward businesses they own or control, further squeezing independent pharmacies out of the market. This lack of transparency and choice does not serve the best interests of seniors who rely on trusted, local pharmacists for their prescription needs.

Additionally, PBMs manipulate drug formularies – the lists of covered medication – to prioritize higher-cost, higher-rebate drugs over more affordable alternatives. This practice forces patients to pay more out-of-pocket for medications that might not be the best option for their health. Instead of prioritizing patient care, PBMs focus on maximizing rebate revenue, leaving seniors facing higher costs for the prescriptions they need.

Thank you for your longstanding leadership in fighting for PBM reform. We strongly support this legislation and look forward to working with you to move it forward in the 119th Congress.

Sincerely,
Andrew J. Mangione Jr.
Senior Vice President
AMAC Action