Legislative Update: Senate Introduces Bipartisan Legislation to Combat Health Care Consolidation

This month, Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) introduced the Break Up Big Medicine Act (S. 3822). The bipartisan legislation, referred to the Senate Judiciary Committee, aims to prohibit pharmacy benefit managers (PBMs), health insurers, and prescription drug or medical device wholesalers from being under common ownership with certain medical service providers or provider groups, including in-patient or outpatient pharmacies. Public interest around vertical consolidation in health care surged following the publication of the Federal Trade Commission’s (FTC) interim staff report on prescription drug middlemen last year. The report identified consequential effects on health care affordability by the actions of the country’s three largest PBMs, which are vertically integrated with insurers, provider groups, and other supply chain entities. FTC followed up on this publication by reaching a landmark settlement with ExpressScripts earlier this year, ordering the company to adopt fundamental changes to its business practices.

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