I 

117TH CONGRESS 

1ST SESSION H. R. 1829 

To require the Government Accountability Office to study the role pharmaceutical benefit managers play in the pharmaceutical supply chain and 

provide Congress with appropriate policy recommendations, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 11, 2021 

Mrs. HARSHBARGER (for herself and Mr. CARTER of Georgia) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To require the Government Accountability Office to study 

the role pharmaceutical benefit managers play in the 

pharmaceutical supply chain and provide Congress with 

appropriate policy recommendations, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Pharmacy Benefit 

5 Manager Accountability Study Act of 2021’’. 


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1 SEC. 2. GAO STUDY. 

2 Not later than 1 year after the date of enactment 

3 of this Act, the Comptroller General of the United States 

4 shall submit to the Committee on Ways and Means, the 

5 Committee on Energy and Commerce, and the Committee 

6 on Education and Labor of the House of Representatives 

7 and to the Committee on Finance and the Committee on 

8 Health, Education, Labor, and Pensions of the Senate a 

9 report that— 

10 (1) addresses, at minimum— 

11 (A) the role that pharmacy benefit man12 agers play in the pharmaceutical supply chain; 

13 (B) the state of competition among phar14 macy benefit managers, including the market 

15 share for the Nation’s 10 largest pharmacy 

16 benefit managers; 

17 (C) the use of rebates and fees by phar18 macy benefit managers, including data for each 

19 of the 10 largest pharmacy benefit managers 

20 that reflects, for each drug in the formulary of 

21 each such pharmacy benefit manager— 

22 (i) the amount of the rebate passed on 

23 to patients; 

24 (ii) the amount of the rebate passed 

25 on to payors; 


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1 (iii) the amount of the rebate kept by 

2 the pharmacy benefit manager; and 

3 (iv) the role of fees charged by the 

4 pharmacy benefit manager; 

5 (D) whether pharmacy benefit managers 

6 structure their formularies in favor of high-re7 bate prescription drugs over lower-cost, lower8 rebate alternatives; 

9 (E) the average prior authorization ap10 proval time for each of the 10 largest pharmacy 

11 benefit managers; 

12 (F) factors affecting the use of step ther13 apy in each of the 10 largest pharmacy benefit 

14 managers; and 

15 (G) the extent to which the price that 

16 pharmacy benefit managers charge payors, such 

17 as the Medicare program under title XXVIII of 

18 the Social Security Act (42 U.S.C. 1395 et 

19 seq.), State Medicaid programs under title XIX 

20 of the Social Security Act (42 U.S.C. 1396 et 

21 seq.), the Federal Employees Health Benefits 

22 Program under chapter 89 of title 5, United 

23 States Code, or private payors, for a drug is 

24 more than such pharmacy benefit managers pay 

25 the pharmacy for the drug; and 


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1 (2) provides recommendations for legislative ac2 tion to lower the cost of prescription drugs for con3 sumers and payors, improve the efficiency of the 

4 pharmaceutical supply chain by lowering inter5 mediary costs, improve competition in pharmacy 

6 benefit management, and provide transparency in 

7 pharmacy benefit management. 

Æ 


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