PBMs, Manufacturers Increased Lobby Spending in 2024
In an Axios analysis of US Senate lobbying disclosures from the past year, researchers explored the ongoing trends of how certain industries distribute influence among legislators.
Pharmacy benefit manager (PBM), drug manufacturer, and physician trade groups all spent more on health care lobbying from 2023 to 2024, according to an Axios report.1
“In the past 5 years, the number of health care-related organizations ranked in the top 10 for lobbying spending at the state Capitol has increased significantly,” wrote David Krechevsky for the Connecticut Hospital Association.2 “There were just 2 health care-related organizations among the top 5 lobbying spenders in the 2-year period of 2019 and 2020, and just 3 among the top 10. For 2021-22, 4 of the top 5 and 6 of the top 10 lobbying spenders were health care-related organizations.”
As many experts familiar with the health care industry are aware, there is a significant amount of money being distributed for a myriad of reasons. Whether it be in the form of manufacturer rebates for prescription drugs or a company’s insurance premiums, money seems to be a notable factor across many providers and professions within health care.
Axios explored the ongoing trends of health care lobby spending from 2024 disclosures. | image credit: VideoFlow / stock.adobe.com
READ MORE: Over 300 Pharmacy Closures Reported in the Last 3 Months
However, aside from the money being distributed to directly help providers deliver care and patients receive it, there is also the increasingly common trend of various health care groups making their industries known in Washington, DC.
“The difference between lobbying and advocacy is that lobbying is a type of advocacy specific to influencing a legislator,” according to Northeast Ohio Medical University.3 “Advocacy is a more general term related to activism on behalf of an issue.”
With increased spending on health care lobbying in recent history, Axios researchers, however, did not see increases among all trade groups and health care industries. The American Hospital Association (AHA), America’s Health Insurance Plans (AHIP), and the Biotechnology Innovation Organization (BIO) all decreased their lobby spending from 2023 to 2024.1
However, including those that increased or decreased spending, each group spent at least $7 million in lobbying, with Pharmaceutical Researchers and Manufacturers of America (PhRMA) leading the way at $31 million. The American Medical Association (AMA) and the Pharmaceutical Care Management Association (PCMA) both spent $3 million more to lobby for physicians and PBMs, respectively.
With constant attention in Congress and amongst bipartisan lawmakers, PBM lobbying year over year may be a trend that stands out the most.
“The pharmaceutical industry has long been pushing for reforms to PBMs' practices, blaming the companies for high drug costs,” wrote Victoria Knight for Axios.1 “PBMs, meanwhile, argue that they're controlling costs in a convoluted health system and have been lobbying against such reforms for several years.”
With pro-PBM lobby spending still hovering below the AHA, AMA, and PhRMA, the PCMA’s increased efforts and the pharmacist profession fighting back highlight the ongoing struggle between the 2 parties. However, as PCMA spending increases and PBM legislation stalls, there is no clear path to industry-wide changes for pharmacists and their reimbursement for services.
Axios researchers owe the increase in PCMA lobbying to the ongoing pressures their industry is facing. “PCMA spent almost $18 million in 2024, compared with $15 million in 2023. And that's after only $9 million total in 2022. The group was fighting multiple bipartisan proposals that would have changed the way PBMs are paid or would have reformed their business practices,” continued Knight.1
With a variety of industry pressures impacting all aforementioned trade groups, each year calls for a different approach to health care lobby spending. From the AMA and its physicians to AHA and Medicare payment structures, these groups are tasked with ensuring their professions receive equitable support from the federal government. However, for pharmacists, their eyes have been on PCMA and how they are working to bolster the PBM industry.
“Powerful health care interests were laser-focused on the possible inclusion of health provisions that would have cracked down on PBMs, reformed drug patents, and delayed scheduled Medicare physician payment cuts,” Knight concluded.1 “Republicans and Democrats spent weeks negotiating a massive end-of-year health package deal that included major PBM reforms as well as a crackdown on drug ‘patent thickets’ that backers say drugmakers use to forestall competition from generics. In the end, most of the health provisions were dropped after President Trump came out against a large year-end bill.”
READ MORE: Bipartisan Bill Aims to Combat PBMs’ Medicaid Spread-Pricing
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