Cantwell, Grassley Urge FTC to Finish Investigation into Pharmacy Benefit Managers’ Practices, Provide Final Recommendations to Congress

The Federal Trade Commission has yet to finalize and release the study it opened in June 2022 

WASHINGTON, D.C – U.S. Senator Maria Cantwell (D-Wash.), Ranking Member of the Senate Committee on Commerce, Science and Transportation and Sen. Chuck Grassley (R-Iowa) are urging the Federal Trade Commission (FTC) to complete its long-running study of pharmacy benefit managers (PBMs) as soon as possible and publicly release a final report with recommendations to Congress.

While the FTC issued interim staff reports in July 2024 and January 2025, the Commission has yet to complete its Section 6(b) study into PBM business practices that was opened in June 2022.

“The interim reports confirm the need for a final assessment,” wrote the Senators. “Both the July 2024 and January 2025 [interim reports] describe how concentration and vertical integration in the PBM industry has given leading PBMs the ability and incentive to increase drug costs, steer patients towards more expensive drug options, and operate with limited transparency.”

The senators praised the FTC’s efforts to secure proposed consent agreements with Express Scripts and Caremark but cautioned more action is needed to hold PBMs accountable and lower drug costs for American families.

“The two interim reports and proposed consent agreements provide substantial information, but they do not complete the study or provide a comprehensive set of recommendations,” the Senators continued. “Congress needs a final report to evaluate whether existing antitrust and consumer protection laws adequately address the identified conduct and whether additional legislation is warranted.”

In 2022, Cantwell and Grassley led a bipartisan letter to then-Chairwoman Lina Khan in support of the study. In January 2024, they led a bipartisan group of senators in another letter urging the FTC to complete its investigation into the nation’s most powerful prescription drug middlemen.

“Prompt completion of the study will provide Congress, taxpayers, plan sponsors, patients, and pharmacies a clearer understanding of competitive conditions in the PBM market and help inform efforts to improve competition, lower prescription drug costs and protect patient access,” the Senators concluded.

Sen. Cantwell has worked for years to bring transparency to the PBM industry and reduce drug prices for Americans. In May 2022, she and Sen. Grassley introduced the bipartisan Pharmacy Benefit Manager Transparency Act to increase drug price transparency and hold PBMs accountable for driving up prescription drug costs. The senators reintroduced the bill in 2023, and again in 2025.

In October 2023, she led a press conference at a Seattle pharmacy to bring awareness to the rapid rise in prescription drug costs. She criticized PBM middlemen for increasing costs for patients and squeezing independent pharmacies.

In July 2024, Sen. Cantwell called on her Senate colleagues to pass the Pharmacy Benefit Manager Transparency Act after the FTC released an interim report revealing that PBMs were intentionally inflating drug costs.

Full text of the letter can be found HERE.

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