Protect Our Nation's Patients & Their Access to Local Pharmacy

Support the Pharmacists Fight Back Act

ABOUT

Why Support the Pharmacists Fight Back Act?

Protect Patient Choice of Pharmacy

Prohibits PBM practices that steer patients to PBM-owned pharmacies and restores patient freedom to use a pharmacy of their choice, increasing access to care.

Rein in PBM Abuses of Taxpayer Dollars

Reins in PBM abuses in federally-funded healthcare programs including: Medicare Part D, Medicare Advantage, Medicare Managed Care, and the Federal Employees Health Benefits Program

Lower Drug Costs and Premiums

Requires PBMs to share a portion of drug manufacturer rebates directly with patients at the pharmacy counter which will return billions of dollars to patients. Any remaining rebates must be used to reduce plan premiums for patients.

Reimburses pharmacies using market based pricing

Pharmacy reimbursement will be centralized using the National Average Drug Acquisition Cost (NADAC) + state Medicaid dispensing fee + 4% preventing the well-documented massive drug cost markups at PBM-owned/affiliated mail-order and specialty pharmacies. Fair and predictable reimbursement for pharmacies aligns drug prices across pharmacies, patients, and payors, and ends PBM markups

Robust Enforcement Ensuring Pharmacies Can Remain Open & Accessible

Provides for strict penalties and robust enforcement mechanisms to ensure maximum PBM compliance with the regulations, ensuring the reforms are implemented effectively and preventing PBMs from circumventing the law.

HOW

Contact Your Legislator

FAQ

Your Questions, Answered

Frequently asked questions

General Questions

The Pharmacists Fight Back Act is "Gold Standard" reform legislation designed to protect patients' access to care at local pharmacies. This legislation, first introduced in 2024 by Representative Jake Auchincloss (D-MA) and Representative Diana Harshbarger (R-TN), is being re-introduced in the 119th Congress as 2 bills:

(1) the Pharmacists Fight Back Act (PFB) which reforms PBM practices in Medicare Part D and Medicaid managed care, and;

(2) the Pharmacists Fight Back Oversight Act (“PFB Oversight”) which reforms PBM practices in the Federal Employee Health Benefits Program.

While there are some technical differences between the two bills, both versions look to address central unfair PBM practices including drug pricing manipulation, steering patients to PBM owned pharmacies, and PBM rebate games that drive up costs for patients at the pharmacy counter.

Patients, community pharmacies, and taxpayers continue to suffer at the hands of PBMs while drug prices skyrocket. Abundant evidence of large PBM practices and abuses in federal healthcare plans includes:

• Hundreds of millions of dollars in spread pricing markup in Medicaid managed care plans

• A large PBM in Part D increased generic drug prices by 51% for seniors at the counter despite those generics’ prices deflating more than 8% during the same period

• Over $60 billion in drug manufacturing and pharmacy discounts denied to Medicare Part D beneficiaries in 2021

• Large PBMs paying their affiliated pharmacies more in Medicare Part D

• PBMs mandating patients receive expensive brand name drugs when cheaper generic drugs were prescribed and available in Medicare Part D, driving up drug costs for seniors at the pharmacy counter and for taxpayers

• Over $39 million in PBM overcharges in the American Postal Workers Union Health Plan administered of the Federal Employee Health Benefit Program

While PBM practices are opaque and complex, the solutions provided in PFB and PFB Oversight offer sensible and simple solutions that will lower costs for patients at the pharmacy counter while paying retail pharmacies transparently and fairly.