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    A new Senate health package includes surprisingly aggressive drug pricing reforms

    Aides and lobbyists expected the new draft proposal to focus more on surprise medical bills than on drug pricing. But its drug pricing policies, particularly toward PBMs, are surprisingly ambitious.
    by Nicholas Florko and Lev Facher May 23, 2019 5 minutes
    Sens. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.)

    WASHINGTON — Two powerful Senate lawmakers laid out an unexpectedly ambitious plan to lower the price of prescription drugs Thursday.

    It came as part of a highly anticipated health care package from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), the duo that helms the Senate health committee that is widely respected for bipartisan health-policy work.

    As recently as Wednesday, aides and lobbyists said the package would be more focused on surprise medical bills than on drug pricing; they expected any policies aimed at the latter issue to be small, targeted, and uncontroversial.

    But the draft legislation includes several aggressive proposals that have the potential to upend the controversial business model of drug industry middlemen known as pharmacy benefit managers. Most notably: The package would ban “,” an industry practice that allows PBMs to pocket the difference between a pharmacy price and wholesale price from

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