The lawmakers introduced legislation to crack down on health care conglomerates that own multiple parts of the industry — including pharmacy benefit managers (PBMs), which act as a conduit between insurers and drug manufacturers, and pharmacies themselves.
Warren and Hawley’s “Break Up Big Medicine Act” proposes prohibiting parent companies from owning a medical provider or management services organization and a PBM or insurer. It also proposes prohibiting parent companies of prescription drug or medical device wholesalers from owning a medical provider or management services organization.
Three PBMs, CVS Caremark, Express Scripts and OptumRX, manage 79 percent of prescription drug claims for roughly 270 million people in the U.S., according to a 2024 report from the Federal Trade Commission (FTC). Those three companies are owned by insurance giants CVS Health, Cigna and UnitedHealth Group, respectively.
A report from the American Medical Association last year said that this vertical integration reduces competition, crowds out smaller insurers and results in higher prices for consumers.
“There’s no question that massive health care companies have created layers of complexity to jack up the price of everything from prescription drugs to a visit to the doctor. The only way to make health care more affordable is to break up these health care conglomerates,” Warren said in a release.
“Our bill would be a monumental step towards ending the stranglehold that corporate giants have on our broken health care system,” she added.
