President-elect Donald J. Trump has announced he will move to eliminate Pharmacy Benefit Managers (PBMs), criticizing them for inflating healthcare costs. Speaking at a press conference at his Mar-A-Lago residence on Monday, Trump argued that PBMs profit excessively without directly contributing to drug manufacturing. He indicated that his nominees for Health and Human Services (HHS) and the Center for Medicare and Medicaid Services (CMS)—Robert F. Kennedy, Jr., and Dr. Mehmet Oz, respectively—have discussed extensive plans to address these issues.

“The horrible middleman that makes more money, frankly, than the drug companies, and they don’t do anything except they’re a middleman. We’re going to knock out the middleman,” Trump said. Meanwhile, Speaker Mike Johnson (R-LA), an ally of the President-elect, plans to initiate measures against big insurance middlemen as part of the year-end government spending package. Johnson is expected to release the spending bill text this week, aligning with Trump’s goal of reducing the influence of PBMs.

PBMs, including CVS Caremark, Express Scripts, and OptumRx, command about 80 percent of the PBM market and oversee drug benefits for over 270 million Americans. Critics argue that PBMs drive up prescription prices by promoting costlier medicines on formularies, which are crucial for determining patient drug access. Pharmacy Benefit Managers’ influence on pricing and available medicines remains highly controversial, with allegations of prioritizing profits over patient needs.

Previously, Trump sought to reform the system by introducing a policy allowing seniors to benefit directly from drug manufacturers’ rebates. However, the Biden government repealed this rule under the Inflation Reduction Act, reversing potential savings for seniors.

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Image by Gage Skidmore.

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