II 

117TH CONGRESS 

1ST SESSION S. 298 

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 SENATE OF THE UNITED STATES 

FEBRUARY 8, 2021 

Mrs. BLACKBURN (for herself and Mr. BRAUN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

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 Finance and the Com5 mittee on Health, Education, Labor, and Pensions of the 

6 Senate and to the Committee on Ways and Means and 

7 the Committee on Energy and Commerce of the House 

8 of Representatives a report that— 

9 (1) addresses, at minimum— 

10 (A) the role that pharmacy benefit man11 agers play in the pharmaceutical supply chain; 

12 (B) the state of competition among phar13 macy benefit managers, including the market 

14 share for the Nation’s 10 largest pharmacy 

15 benefit managers; 

16 (C) the use of rebates and fees by phar17 macy benefit managers, including data for each 

18 of the 10 largest pharmacy benefit managers 

19 that reflects, for each drug in the formulary of 

20 each such pharmacy benefit manager— 

21 (i) the amount of the rebate passed on 

22 to patients; 

23 (ii) the amount of the rebate passed 

24 on to payors; 

25 (iii) the amount of the rebate kept by 

26 the pharmacy benefit manager; and 


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1 (iv) the role of fees charged by the 

2 pharmacy benefit manager; 

3 (D) whether pharmacy benefit managers 

4 structure their formularies in favor of high-re5 bate prescription drugs over lower-cost, lower6 rebate alternatives; 

7 (E) the average prior authorization ap8 proval time for each of the 10 largest pharmacy 

9 benefit managers; 

10 (F) factors affecting the use of step ther11 apy in each of the 10 largest pharmacy benefit 

12 managers; and 

13 (G) the extent to which the price that 

14 pharmacy benefit managers charge payors, such 

15 as the Medicare program under title XXVIII of 

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

17 seq.), State Medicaid programs under title XIX 

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

19 seq.), the Federal Employees Health Benefits 

20 Program under chapter 89 of title 5, United 

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

22 more than such pharmacy benefit managers pay 

23 the pharmacy for the drug; and 

24 (2) provides recommendations for legislative ac25 tion to lower the cost of prescription drugs for conVerDate Sep 11 2014 01:56 Feb 27, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S298.IS S298

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1 sumers and payors, improve the efficiency of the 

2 pharmaceutical supply chain by lowering inter3 mediary costs, improve competition in pharmacy 

4 benefit management, and provide transparency in 

5 pharmacy benefit management. 

Æ 


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