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Bob Herman covers health insurance, government programs, hospitals, physicians, and other providers — reporting on how money influences those businesses and shapes what we all pay for care. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

The Trump administration’s desire to pry open the black box of prescription drug prices is facing stiff opposition from the phalanx of lobbyists representing pharmacy benefit managers and health insurers.

In January, the Department of Labor proposed a rule that would mandate PBMs disclose a wide range of drug pricing information to employers and make it easier to be audited. The public had until last week to submit comments.

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A review of the more than 500 letters that poured in reflects a melange of drug pricing interests: predictable resistance from PBMs and health insurers, which generate billions of dollars in profit every year from their role as gatekeepers of drug spending; enthusiasm from Mark Cuban’s pharmacy and others in the business community who want middlemen to face more accountability; and a semblance from the pharmaceutical industry of having one’s cake and eating it, too: Drug companies cheered PBMs being in the regulatory crosshairs but wanted pullback on disclosure of drug pricing data. 

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