PBMs Should Be Health Plan Fiduciaries, Employers Tell Congress

Pharmacy benefit managers should be required to act as fiduciaries acting in the interest of health-plan beneficiaries in providing benefits and paying plan expenses, a House subcommittee was told at a Tuesday hearing.

Three PBMs—CVS Health, Optum RX, and Express Scripts—"have taken over the market share” for self-insured health plans, controlling the prescription drugs that are covered on health plan formularies and price rebates on those drugs, said Russell DuBose, vice president of human resources for Tuscaloosa, Ala.-based manufacturer Phifer Inc. DuBose was one of several speakers at the hearing before the health subcommittee of the ...