Coalition Launches to Reform PBM Practices that Jeopardize Patient Care and Public Health

Patient advocates, doctors, pharmacy, retail, health care, small business groups say underwater reimbursements, patient steering, and other PBM practices restrict patient access and increase costs

NCPA September 23, 2021

Washington, D.C. (Sept. 23, 2021) — Six national organizations who counsel patients, treat patients, advocate for patients, or provide prescription drug benefits to employees and their families joined forces today in a new coalition aimed at bringing transparency to a part of the health care system dominated by a few giant corporate middlemen but which very few people understand.

The Coalition for PBM Reform which represents independent pharmacies, grocery stores, chain pharmacies, small businesses, health care providers, and patients, is the largest and most diverse effort yet to change the way pharmacy benefit managers operate. The members include: the National Community Pharmacists Association (NCPA), the FMI - Food Industry Association (FMI), the AIDS Healthcare Foundation (AHF), the National Federation of Independent Business (NFIB), the Coalition of State Rheumatology Organizations (CSRO), and the Community Oncology Alliance (COA).

“Our organizations represent millions of patients, hundreds of thousands of employers, and thousands of health care providers whose access to medicine is threatened by a handful of companies that dominate the prescription drug industry. These companies decide prescription drug benefits, set prices, limit access, and threaten the viability of local health care providers. Moreover, they do so without treating or counseling a single patient, and without providing insurance coverage to a single employee or family.

“The three largest PBMs are all Fortune 15 companies. They control nearly 80 percent all prescriptions filled in the United States. Since they work for the largest insurance plans, public and private, their practices affect the cost of prescription drugs for most Americans and most employers. Nevertheless, they operate far outside of the public view. In fact, the terms they impose on patients, providers, and employers are negotiated completely without scrutiny. Transparency and information are the keys to any healthy market. They form the basis on which consumers can make decisions. Those elements are largely absent from the prescription drug market, and this coalition aims to change that.”

NCPA CEO B. Douglas Hoey, pharmacist, MBA, said,There is no transparency in how PBMs price medicines, reimburse pharmacies, or determine how much patients will pay at the counter. Transparency is essential to any healthy market. There is none in the prescription drug market. Americans pay the highest drug prices in the world. And we’re the only country that has turned over prescription drugs to PBMs. We don’t think that’s a coincidence. 

“NCPA has been fighting to reform the PBMs for many years. We’ve been fortunate to have worked with many of the members of this coalition on specific issues. This is the first time we’ve been part of such a broad coalition. Independent pharmacies, supermarket pharmacies, small business employers, patient advocates, and doctor groups are finally united. Separately, we’ve all made progress. United, we can turn the tide.

For more information about the Coalition for PBM Reform, please visit


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit