NCPA Endorses Reintroduced Patients Before Monopolies Act

ALEXANDRIA, Va. (May 13, 2026) – The National Community Pharmacists Association is pleased to support the Patients Before Monopolies Act, which would force companies that own health insurers or pharmacy benefit managers to divest their pharmacy businesses within three years. First introduced in December 2024, it is being reintroduced today in both the House and Senate. In the House, it’s being led by Reps. Diana Harshbarger (R-Tenn.), Jake Auchincloss (D-Mass.), Greg Landsman (D-Ohio), Buddy Carter (R-Ga.), Jerry Nadler (D-N.Y.), and Troy Nehls (R-Texas), and in the Senate by Sens. Elizabeth Warren (D-Mass.), Josh Hawley (R-Mo.), Roger Marshall (R-Kan), and John Fetterman (D-Pa.).

The Patients Before Monopolies Act aims squarely at the conflicts of interest created by vertically integrated PBMs by prohibiting a parent company from owning both a PBM/health insurer and a pharmacy; requiring divestiture of pharmacy assets within one year; establishing strong enforcement; enabling private right of action; and preventing re-consolidation that would recreate the same anticompetitive structure.

“The giant corporate PBMs are trying to use smoke and mirrors to convince members of Congress and state legislators that there’s nothing wrong with their business practices. But we know better,” says NCPA CEO B. Douglas Hoey, pharmacist, MBA. “They often steer patients away from competing pharmacies and into their chain location or their mail-order pharmacy — even if their steering has a detrimental effect on patients. They reimburse their own pharmacies higher amounts than they reimburse competing pharmacies for the same prescriptions, just one tactic that forces independent pharmacies to close and robs patients of access to care.

“PBMs have a choice — operate as a PBM or operate as a pharmacy, but you can’t have it both ways. Having both functions under one roof is a huge conflict of interest and drives up prescription drug prices. The Patients Before Monopolies Act is critical in supporting patients and independent pharmacies and restoring a free market. NCPA is proud to support it and thanks Reps. Harshbarger, Auchincloss, Landsman, Carter, Nadler, and Nehls, and Sens. Warren, Hawley, Marshall and Fetterman for their leadership.”