1. United States
2. S.C.
3. Letter

The Patients Before Monopolies Act aims to prohibit the common ownership of pharmacies and pharmacy benefit managers (PBMs) or insurance companies. This bipartisan legislation seeks to address concerns over alleged anticompetitive practices and harm resulting from the vertical integration of PBMs and pharmacies. The bill would make it unlawful for any entity to own or control both a pharmacy and a PBM or insurance company. While the bill provides a three-year grace period for non-compliant entities to divest their pharmacy operations, it does not allow for the divestment of PBM or insurance operations. This suggests that companies would need to exit the pharmacy business rather than the insurance side. The PBM Act grants enforcement authority to various federal and state agencies, including the Department of Health and Human Services, the Department of Justice, the Federal Trade Commission (FTC), and state attorneys general. Violations could result in court orders for cessation, divestment, and disgorgement of pharmacy revenue into an FTC-managed fund to serve harmed communities. This legislation aligns with recent heightened scrutiny of PBMs, including FTC investigations, congressional hearings, and state lawsuits alleging anticompetitive practices. Given the potential impact on ownership structures, affected providers should assess their business arrangements to understand the implications of this bill. The request is for the Act to be passed, recognizing its aim to address concerns over vertical integration and alleged competitive harms in the pharmaceutical industry. However, a thorough evaluation of the potential consequences, both intended and unintended, would be prudent before enacting such a significant structural change.