Patients Not PBMs Coalition Renews Public Push for Legislative Action to Reform PBMs
For Immediate Release
Contact: Erin Hearn, c: (781)243-2872
ehearn@jstrategiesinc.com
Coalition Releases New Ads Showing How Pharmacy Benefit Managers (PBMs) Continue to Grab Savings Meant for Patients
October 15, 2025 / Boston, MA – Today, Patients Not PBMs, a coalition of patient advocacy organizations, independent pharmacists and local business groups, announced the release of two new digital ads, “Ripping Us Off” and “Scheme”, to bring renewed attention to the role of PBMs in grabbing savings meant for patients at the pharmacy counter
The launch of the new ads, which are running on digital and streaming platforms statewide, is part of a renewed push by Patients Not PBMs for legislative action to curb the abusive practices of PBMs and to bring greater transparency to their actions.
“At a time when so many Massachusetts residents face higher costs at every turn, along with a great deal of uncertainty around healthcare access, it is time to finally rein in the unchecked and fraudulent practices of PBMs which grab savings meant for patients at the pharmacy counter,” said Haley Director, MPH, Director, Rare New England. “We are hopeful the legislature is ready to take meaningful action to end some of the most abusive and costly practices of PBMs.”
Transcript: “Pharmacy Benefit Managers. They’re the middlemen raising the cost of prescription drugs. The more expensive the drug, the more they make. PBMs were caught blocking patients from buying lower cost drugs because they make less, so Massachusetts needs a new law to stop PBMs from getting rich by making you pay more. That would lower the cost of prescription drugs and save money for taxpayers. The PBMs are ripping us off. Tell Beacon Hill it's time to stop them.”
Transcript: “There’s a twisted trick that’s raising drug costs here in Massachusetts, led by middlemen known as Pharmacy Benefit Managers. They make money by jacking up your prices. PBMs block patients from buying lower cost drugs in order to maximize their profit. Massachusetts is considering a new law to end this twisted trick and stop PBMs from pushing pricier drugs onto patients. Tell Beacon Hill it’s time to stop PBMs from raising our costs.”
Both the House and Senate have expressed support for PBM reform in the most recent legislative session, with several proposals that included meaningful reforms that benefit patients and community pharmacies. This aligns with momentum happening across the country, with more than 60 states introducing PBM reform bills in 2025, and 39 Attorneys General, including Massachusetts Attorney General Andrea Campbell, expressing their concerns that PBMs profit at the expense of patients and employers, and urging Congressional action.
Last spring, a coalition of patient advocacy groups sent a letter to legislative leaders to support PBM reform, aimed at delinking PBM compensation from the price of medicine, requiring PBMs to pass through manufacturer rebates and discounts directly to patients to their reduce out-of-pocket costs, establishing a duty of care for PBMs, banning spread pricing, enacting patient assistance protection, and requiring PBMs to provide a reasonably adequate and accessible network with convenient access to pharmacies, among other reforms.
One example of how PBM’s inflate drug prices is around insulin – a widely-used drug to manage diabetes which, according to the American Diabetes Association, approximately 171,000 adults in Massachusetts rely on. The FTC is suing PBMs for inflating insulin prices, alleging they favor high list price, highly-rebated versions over lower cost alternatives. This is in addition to their investigation into PBMs focusing on anti-competitive practices. The FTC released a second interim report in 2025, which confirmed PBMs profit at the expense of patients and are driving up drug prices.
“Independent pharmacies play a critical role in our communities, ensuring patients receive life-saving medications while providing immunizations and other critical services,” said Todd Brown, Executive Director of the Massachusetts Independent Pharmacists Association. “The time has come to simplify the pharmacy benefit, including reimbursement to pharmacies, and stop PBMs from manipulating the system to their own advantage at the expense of employers and patients.”
Background on PBMs
When patients pay for prescription drugs, more than half of the money goes to entities like insurance companies and their PBMs -- who act like middlemen and pocket billions of rebate dollars every year. PBMs are some of the most profitable corporations that most Americans have never heard of. In 2024 alone, rebates, discounts and payments made by brand drug manufacturers to middlemen, the government, and others totaled $356 billion, but PBMs and insurers kept much of the rebate dollars for themselves.
Today’s “big three” PBMs – Express Scripts, CVS Caremark, and OptumRx, owned by UnitedHealth Group – control nearly 80% percent of the prescription drug market, covering roughly 270 million Americans, and grab tens of billions of dollars in rebates and discounts on medicines that should be passed on to consumers. PBMs claim to “extract” savings on prescription drugs, but as federal and state lawmakers, regulators, the media and patients have found, these savings often don’t make it to patients. PBMs have been found to pocket patient savings, drive up costs and decrease access to life-changing treatments.
About Patients Not PBMs Coalition
Patients Not PBMs was established in the spring of 2023 to push for legislation to force transparency around pharmacy benefit managers, or PBMs, and their impact on drug costs. The coalition would like to see bills passed in the Massachusetts legislature that would require PBMs – who act like middlemen -- to be more transparent and to stop keeping rebates intended for patients and reimburse pharmacies fairly
Patients Not PBMs coalition members include Lupus Foundation New England, RARE New England, Diabetes Patient Advocacy Coalition (DPAC), Infusion Access Foundation, National Infusion Center Association (NICA), Patient Pocket Protector Coalition, Coalition of State Rheumatology Organizations (CSRO), Asthma and Allergy Foundation of America New England, Institute for Pediatric Innovation, Alliance for Patient Access (AfPA), Massachusetts Pharmacists Association (MPhA), Massachusetts Chain Pharmacy Council, Massachusetts Independent Pharmacists Association (M.I.P.A.), Cambridge Chamber of Commerce, Pharmaceutical Industry Labor-Management Association (PILMA), National Association of Chain Drug Stores (NACDS) and PhRMA.
