Arlington, VA— In comments submitted in response to the Listening Sessions on Lowering Americans’ Drug Prices Through Competition (June 30, July 24, and August 4, 2025), the American Consumer Institute (ACI) highlighted serious concerns about the role of Pharmacy Benefit Managers (PBMs) in inflating pharmaceutical costs and limiting access to affordable medications.
ACI’s comments detailed how PBMs manipulate formularies to favor high-cost brand drugs over generics, enabling spread pricing that benefits PBMs at the expense of patients and insurers. These practices, including clawback fees, performance fees, and pharmacy steering, have undermined the viability of independent pharmacies—especially in rural and minority communities.
At the core of these issues is a lack of transparency. ACI emphasized that stakeholders—including insurers, patients, pharmacies, manufacturers, and regulators—do not have access to key information needed to make informed decisions.
ACI called for comprehensive transparency requirements, including PBM disclosures on fees, rebates, discounts, drug pricing, and formulary placements. Such measures would enable competition, inform policy, and help reduce drug costs for consumers.
Read the full letter below
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The American Consumer Institute is a nonprofit education and research organization.