Letter of Support for Pharmacy Benefit Managers Reform

The following memo was also sent to: Congresswoman Rosa DeLauro, Congresswoman Jahana Hayes, Congressman Jim Himes, Congressman John Larson, and U.S. Senators Richard Blumenthal and Chris Murphy.

September 3, 2025

Congressman Joe Courtney

2449 Rayburn House Office Building

Washington, DC 20515

Dear Congressman Courtney:

On behalf of We Work for Health CT and the undersigned organizations, we respectfully urge you to prioritize passing critical legislation to reform the current practices of Pharmacy Benefit Managers (PBMs). PBMs continue to drive up prescription drug costs for patients in Connecticut and across the country, while bipartisan reform proposals languish due to broader political dynamics. These reforms have reached the legislative “finish line” multiple times but support from both parties remains strong. Now is the time to utilize that momentum to enact cost-saving and transparency measures.

Specifically, we are asking our federal delegation members to support reforms that delink PBM compensation from the cost of medications and ensure that any savings within the pharmaceutical supply chain benefit American employers and patients—not the corporate profits of middlemen. These measures include separating PBM profits from drug prices, ensuring that patients pay the minimum cost for prescriptions, and increasing transparency in PBM pricing practices.

As Congress returns to work in Washington, we strongly urge you to move forward with these bipartisan reform proposals. Too many Americans are suffering from higher medication costs, limited pharmacy options, and a lack of transparency within the system. The current business practices of PBMs have allowed a few corporations to control over 80% of the market, leaving patients and employers to bear the brunt of rising drug prices while PBMs reap significant profits.

To address these issues, we request that the following reforms be urgently prioritized:

• Separate, or ‘delink’ PBM Revenues from Drug Prices: PBMs should earn only flat administrative fees for services they provide- not a percentage of the total drug cost.

• Ban Spread Pricing and Mandate Transparency: Legislation should ban the PBM practice of spread pricing, which incentives PBMs to turn a profit by charging health plans a higher price for a prescription drug than the amount the PBMs pay the pharmacy to dispense it. Public and private health plans must have access to detailed pricing data, including all rebates, discounts, and fees received by PBMs, to ensure that they are not manipulating prices for profit.

• Ensure Patients Pay the Minimum Cost for Medications: PBMs should pass all discounts, rebates, and related revenues directly to patients and health plans. Patient out-of-pocket costs must be based on the discounted acquisition cost of medications, not inflated list prices.

In addition to Connecticut patients, these reforms will save employers, the federal government, and American families real dollars at the pharmacy counter.

We urge you to act swiftly and decisively to address the growing financial burden on patients and families, and we stand ready to work with you to make these reforms a reality.

Sincerely,