TOPEKA, Kan. (AP) \u2014 As consumers worry about medication costs, states are trying to lower drug prices by reining in big companies that oversee prescription coverage for health insurers. <\/p>\n
Some of those companies, called pharmacy benefit managers, also own pharmacies, and one of them, CVS, has spent millions of dollars fighting the regulations. <\/p>\n
Affordability is a key issue ahead of this year\u2019s midterm elections. Legislators in at least a dozen states passed laws this year to limit compensation to the companies, set minimum payments from the companies to pharmacists and require the companies to disclose more information to their clients, states and the public.<\/p>\n
A Tennessee law will bar pharmacy benefit managers from operating retail pharmacies as of July 1, 2028, though CVS Health Corp. has filed a federal lawsuit to avoid having to close its 136 pharmacies there. <\/p>\n
About 6 in 10 U.S. adults said in a poll conducted earlier this year<\/a> by healthcare research nonprofit KFF that they were at least somewhat worried about being able to afford their prescriptions. About 4 in 10 said costs had led them not to take medications as prescribed within the previous year, either by taking less than the prescribed dose, using over-the-counter substitutes or not filling prescriptions. <\/p>\n Dozens of proposals emerge across the US<\/p>\n Pharmacy benefit managers, particularly CVS and two other large companies, handle most U.S. prescriptions.<\/p>\n Lawmakers in at least 26 states introduced more than 120 bills this year on PBMs, according to an Associated Press search using the bill-tracking software Plural,<\/a> with about a quarter<\/a> of the bills clearing at least one chamber. <\/p>\n The companies manage pharmacy claims for health insurers and negotiate with manufacturers over drug prices and what medications will be covered. Critics concede that the size of the top companies gives them leverage that health plans wouldn\u2019t have on their own.<\/p>\n The benefit managers argue that they\u2019re the only player in the drug supply chain created to help push drug costs down and they claim credit for an increased used of less-expensive generic drugs, now 90% of U.S. prescriptions. <\/p>\n \u201cIf PBMs already didn\u2019t exist, you\u2019d need to invent one,\u201d Prem Shaw, president of the CVS Health group overseeing its pharmacy and PBM operations, said in a recent interview. \u201cBlaming PBMs for high drug prices is like blaming umbrellas for the rain.\u201d<\/p>\n CVS fights restrictions in Tennessee<\/p>\n Drug companies, PBMs and their allies have spent at least $24 million on opposing broadcast and digital advertising since the start of 2025 to influence public opinion, according to the ad-tracking firm AdImpact. CVS spent $4 million this year on ads opposing Tennessee\u2019s new law.<\/p>\n CVS sued Arkansas last year after it enacted similar legislation, and a federal judge blocked<\/a> its law. CVS also settled three lawsuits<\/a> in which Louisiana accused it of unfair trade and deceptive practices in lobbying against legislation there last year, agreeing to pay $45 million without acknowledging wrongdoing.<\/p>\n The CVS lawsuit in Tennessee alleges that the company, which operates 9,000 pharmacies nationwide, is facing \u201cnaked protectionism\u201d from lawmakers who operate independent pharmacies \u2014 including the law\u2019s main sponsor, state Sen. Bobby Harshbarger, and co-sponsor Sen. Shane Reeves. <\/p>\n