Congress moves to ban hidden pharmacy middleman markups, forcing price transparency.
S. 3345 — PBM Price Transparency and Accountability Act · Filed by Mike Crapo (R-ID) · 27 cosponsors · Introduced Dec 4, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill requires pharmacy benefit managers (PBMs) and states to use transparent, pass-through pricing for prescription drugs under Medicaid and Medicare, banning 'spread pricing' (where PBMs pocket the difference between what they charge and what they pay pharmacies). It mandates detailed reporting on drug costs, rebates, and fees; establishes 'any willing pharmacy' participation rules for Medicare plans; and creates enforcement mechanisms with civil penalties for non-compliance. The bill aims to lower drug costs for beneficiaries and ensure independent pharmacies can participate in networks.
Why we flagged it
The bill's core mechanism is mandating transparent pass-through pricing for prescription drugs and eliminating hidden PBM markups, with extensive reporting and enforcement provisions. This is fundamentally a price-transparency and accountability measure targeting intermediary profit-taking.
What the text implies
- PBMs may respond by consolidating with pharmacy chains or manufacturers to maintain revenue, potentially reducing independent pharmacy participation despite 'any willing pharmacy' language.
- Detailed reporting requirements on rebates and manufacturer relationships may expose proprietary negotiating strategies, potentially shifting bargaining power toward large manufacturers.
The full analysis lists 5 implications of this text.
Who stands to gain
Independent retail pharmacies; Medicare and Medicaid beneficiaries (lower out-of-pocket costs); State Medicaid programs (reduced spread pricing costs)