Executives from the three biggest PBMs — CVS Caremark, OptumRx and Express Scripts — are expected to testify. 

PBMs negotiate the terms and conditions for access to prescription drugs for hundreds of millions of Americans. They are responsible for negotiating prices with drug companies, paying pharmacies and determining which drugs patients can access and how much they cost.   

The GOP-led House Oversight and Accountability Committee has been one of the committees investigating PBMs, though it’s not one that’s been involved in negotiating legislation.

Congressional pressure on PBMs has been building, and bipartisan bills to change certain PBM business practices have cleared two Senate committees. But major policy disagreements between House and Senate Republicans in terms of the scope of the changes led to them being sidelined, likely until a lame duck session after the November elections.  

The hearing Tuesday could be an effort to jumpstart efforts to include PBM reforms in any year-end spending package.  

“Both Republicans and Democrats on the House Oversight Committee have sounded the alarm over anticompetitive tactics deployed by pharmacy benefit managers and their role in rising drug prices,” Oversight Committee Chair James Comer (R-Ky.) said in a statement.  

“Information the Committee has obtained shows spread pricing and rebates benefit PBMs and have helped the three largest PBMs monopolize the pharmaceutical market,” Comer said. 

Drugmakers blame PBMs for the high costs of prescription drugs, though the PBM industry says their role is misunderstood. Executives at the hearing are likely to point fingers at the manufacturers.   

“Too many recent conversations around PBMs reflect a one-sided view informed directly by the pharmaceutical industry’s blame game designed to vilify PBMs to keep prescription drug prices high and increase drug company profits,” said JC Scott, president and CEO of the PBM trade group Pharmaceutical Care Management Association.