A bill to prohibit pharmacy benefit managers and pharmacies from being under common ownership, and for other purposes.

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [S. 4509 Introduced in Senate (IS)] <DOC> 119th CONGRESS 2d Session S. 4509 To prohibit pharmacy benefit managers and pharmacies from being under common ownership, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES May 13, 2026 Ms. Warren (for herself, Mr. Hawley, Mr. Fetterman, and Mr. Marshall) introduced the following bill; which was read twice and referred to the Committee on the Judiciary _______________________________________________________________________ A BILL To prohibit pharmacy benefit managers and pharmacies from being under common ownership, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Patients Before Monopolies Act'' or the ``PBM Act''. SEC. 2. FINDINGS. The Congress finds the following: (1) Pharmacy benefit managers are corporate entities that play a dominant role in pharmaceutical supply chains, determining which drugs health plans will cover for enrollees, what prices patients and health plans will pay for those drugs, and how much health plans will reimburse pharmacies for dispensing them. (2) The market for pharmacy benefit manager services has become highly concentrated. As of 2025, the 6 largest pharmacy benefit managers are each integrated into large health care conglomerates that include downstream businesses such as retail, mail order, and specialty pharmacies. These conglomerates also processed more than 90 percent of the prescriptions in the United States in 2023. (3) The 3 largest pharmacy benefit managers are also vertically integrated into health care platforms that include both upstream business lines, like health insurance, and downstream suppliers, like pharmacies and providers. (4) The Federal Trade Commission has found that ver