Bill · S. 4509· Senate(119-S-4509)
PBM Act
- Introduced
- 5/13/2026
- Last activity
- 5/13/2026 — Read twice and referred to the Committee on the Judiciary.
- Sponsored by
- Elizabeth Warren
- Cosponsors
- - 1 - 2
- Introduced
- In Committee
What this bill would do
The "Patients Before Monopolies Act" aims to prohibit the common ownership of pharmacies and pharmacy benefit managers or insurance companies. It targets large health care conglomerates that are vertically integrated, which the bill suggests can reduce competition and increase drug costs. Under this law, any entity owning both a pharmacy and a pharmacy benefit manager or insurance company must divest their pharmacy business within one year. The bill empowers the FTC and DOJ to enforce these separations and block future transactions that create these conflicts. It also establishes legal avenues for federal agencies, state attorneys general, and private citizens to bring civil actions.
Yes· 3 of 7
Does this lower the price of prescription medicines?+8
The bill aims to lower drug costs by eliminating the incentive for vertically integrated companies to steer business to their own pharmacies.
Does this give people more protection from unfair business practices?+7
The bill protects consumers from higher prescription drug costs caused by vertical integration and self-preferencing.
Would business owners be better off under this?+6
Independent pharmacy owners are protected from the market pressure exerted by large pharmacy benefit managers.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Increased Competition and Lower Costs: By prohibiting vertical integration, the bill seeks to stop companies from steering business to their own pharmacies, which the text states reduces competition and increases prescription drug costs for patients (Section 2).
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Protection for Independent Pharmacies: The act aims to protect independent pharmacies that face pressure from large pharmacy benefit managers to enter into unfavorable contracts (Section 2).
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Restoration of Market Competition: The bill intends to eliminate conflicts of interest to restore competition to the marketplace (Section 2).
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Financial Redress for Consumers: In civil actions, courts may award damages to individuals, and revenue from illegal pharmacy sales can be placed into a fund to serve the health care needs of harmed communities (Section 3).
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Accountability for Large Conglomerates: The bill requires companies to divest pharmacy businesses to prevent them from using transfer pricing to hide profits and evade statutory limits like the Medical Loss Ratio (Section 2).
Potential Negative Impacts for People
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Mandatory Divestment Burdens: Companies found in violation of the act are required to divest their pharmacy businesses within one year, which may involve oversight by a divestiture trustee (Section 3).
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Financial Penalties: Entities that fail to meet specific divestment milestones may have 10 percent of their profits transferred into an escrow account monthly (Section 3).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Business Owners+6Good For Low Income Households+5Good For Middle Class Households+5Good For Urban Residents+3
- Healthcare
- Reduces Prescription Drug Costs+8
- Economy And Finance
- Improves Consumer Protection+7
- Social Issues And Justice
- Improves Poverty Reduction+2
- 5/13/2026
- Read twice and referred to the Committee on the Judiciary.
- 3 Cosponsors added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
John FettermanDemocrat · Pennsylvania
Josh HawleyRepublican · Missouri
Roger MarshallRepublican · Kansas