MONTVALE, N.J., Feb. 26, 2025 -- EmpiRx Health, the leading clinically-driven pharmacy benefits management (PBM) company, announced that it commends Congressman Brett Guthrie (KY-02),
Chairman of the House Committee on Energy and Commerce, and Congressman Earl L. "Buddy" Carter (GA-01), Chairman of the Subcommittee on Health, for convening a hearing today on reforming the discredited business practices of the largest PBM companies. Today's hearing, An Examination of How Reining in PBMs Will Drive Competition and Lower Costs for Patients, is focused on reigniting the PBM reform measures that have garnered strong bipartisan support over the past year.
The hearing will address the skyrocketing costs of prescription drugs that pose a serious threat to the nation's healthcare system; the proliferation of hyper-expensive specialty medications has made this problem even worse. PBMs were originally formed over 50 years ago to help organizations effectively manage these growing costs. However, today's traditional PBMs prioritize their profits over reducing drug costs and improving patient health outcomes.
The Big 3 PBM companies, which control more than 80% of the pharmacy care market, act more like financial trading firms instead of healthcare organizations. These legacy PBMs have embraced a volume- driven, rebate-centric business model that has exacerbated the problem of rising drug costs rather than offering vital solutions.
Danny Sanchez, Chief Executive Officer of EmpiRx Health, issued the following statement on the urgency of comprehensive PBM reform:
"If Congress is serious about lowering drug costs for Americans, PBM reform must be part of that conversation. Prescription drug costs are rising by more than 5% each year and PBMs, whose founding mission was to help control these costs, are chasing higher profits instead of addressing the needs of benefits plan sponsors and patients.
We were pleased to see PBM reform measures included in the first iteration of the year-end spending bill last December and hope they serve as the starting point for comprehensive PBM reform going forward. We ask Congress, however, to make sure that any PBM reform measures extend to the commercial market as well. More than 164 million Americans rely on employer-sponsored health benefits plans, and they are paying an unacceptably high price for the dysfunctional business model of the biggest PBMs.
The major PBM reform measures that have attracted bipartisan support are, in our view, table stakes in this legislative process. These measures include eliminating spread pricing, requiring full rebate pass- throughs to plan sponsors, and implementing transparency requirements. For PBM reform to be truly effective, we also need to look at ending the anticompetitive practices within the PBM industry, including the vertical integration that has allowed PBMs to morph into healthcare industry conglomerates that exercise undue control over every aspect of pharmacy benefits care.
There is no reason why the top three PBMs should belong to parent companies that also own insurers and pharmacies. This presents an inherent conflict of interest and is why EmpiRx Health strongly
supports legislation like the Patients Before Monopolies (PBM) Act, proposed by Senators Josh Hawley and Elizabeth Warren, alongside Representatives Diana Harshbarger and Jake Auchincloss, that would prohibit collective ownership of both PBMs and pharmacies.
We look forward to working with Congress to advocate for, and ultimately enact, meaningful PBM reform. In fact, EmpiRx Health's clinically-driven pharmacy care approach that puts pharmacists back in the center of the PBM model, has been paving the way for the future of our industry. It's a future where PBMs return to their founding healthcare mission, which is centered on improving the health and well- being of patients while lowering the costs of prescription drugs."
About EmpiRx Health
EmpiRx Health is the leading clinically-driven, customer-first pharmacy benefits management (PBM) company that puts the pharmacist at the center of the pharmacy care model. Leveraging our AI- powered pharmacy care platform, Clinically™, EmpiRx Health's clinical pharmacists and client experience teams provide the highest quality care and service. This enables plan sponsors to measurably improve their member health outcomes while substantially reducing prescription drug costs. With major offices in Montvale, NJ and Orlando, FL, EmpiRx Health celebrated its 10-year anniversary in 2024. To learn more, visit www.empirxhealth.com. More information on Clinically can be found at www.clinically.co.
For EmpiRx Health:
Stephanie Cox
Phone: (201) 775-6971
Email: SCox@empirxhealth.com
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