WASHINGTON — Lawmakers from both sides of the aisle on Wednesday came down hard on various sectors of the U.S. prescription drug supply chain during a hearing to shed light on the reasons for rising costs.

At a House Energy and Commerce Health Subcommittee hearing, Rep. Brett Guthrie, R-Ky., touted changes in the fiscal 2026 spending package enacted this month to improve pharmacy-benefit manager pricing transparency and reduce incentives for PBMs to promote higher-priced drugs to Medicare Part D beneficiaries.

But Guthrie stressed that further changes could be forthcoming.

“Historic PBM reform is just the beginning,” said Guthrie, who chairs the full Energy and Commerce panel. “More needs to be done throughout the drug supply chain to improve affordability.”

Rep. Morgan Griffith, R-Va., chair of the Health Subcommittee, said after the hearing that he hopes to mark up affordability legislation before Memorial Day, but acknowledged the appetite for bipartisan cooperation will be “tough” given the political climate.

The hearing is the committee’s latest push on health care affordability. The panel last month grilled the CEOs of major insurance companies, who often struggled to directly answer lawmakers’ questions on what they’re doing to lower costs for patients.

The hearing also comes as drug pricing has moved into the spotlight in 2026.

Last week, Democrats on the Senate Finance Committee unveiled their outline for lowering drug prices. The plan seeks to expand the drug negotiation provisions in President Joe Biden’s 2022 reconciliation law and examine ways to lower prices for people who have employer-sponsored insurance.

Pointing fingers

The nine witnesses who testified during Wednesday represented a wide range of the supply chain, including PBMs as well as biotech and pharmaceutical industry players.

Lori Reilly, the chief operating officer at PhRMA, the main lobbying organization representing the pharmaceutical industry, laid blame on the business practices of PBMs for causing independent pharmacies to close.

“The unique challenges that we face in our system are in part because we have a convoluted supply chain that exists in our system that does not lower cost, oftentimes, for patients, and actually puts hurdles in the way to patients being able to access medicine,” she told lawmakers.

The head of the Pharmaceutical Care Management Association, which represents PBMs, responded by blaming “other sectors” for spending millions of dollars to unfairly cast PBMs in a poor light.

David Marin, who began his role as president CEO of PCMA just last month, said that the group has “failed” at explaining to policymakers the role that PBMs play in the health care system.

“In just a few short days, it’s become clear to me, we have allowed other sectors, including some here today, to misrepresent us, often wildly so, and cloud the facts of policymakers,” he said.

Griffith pressed Marin on the market consolidation within the PBM industry, noting that the three largest — CVS Caremark, Express Scripts and OptumRx — control 80% of the market.

Marin pushed back, saying that there is healthy competition.

“We see the small players taking business from the big players all the time,” he said.

Most favored nation

The hearing also drew attention to President Donald Trump’s pitch to codify his “most favored nation” approach to drug pricing, under which he has struck individual deals with pharmaceutical companies to lower U.S. prices to match those in other countries.

John Crowley, the CEO of the Biotechnology Innovation Organization, warned against the proposal, arguing it would impede innovation and would risk bringing socialized medicine to the United States.

“We must remember the United States already is the most favored nation when it comes to developing groundbreaking new medicines that transform the standard of care for patients,” he said.

Rep. Frank Pallone Jr., D-N.J., ranking member of the full committee, criticized Trump’s individual deals with pharmaceutical companies as opaque.

Griffith agreed to work with Democrats on the panel to seek more information on what was included in the agreements.

“I’m happy to work with you, Mr. ranking member, in order to try to get as much information as we can without busting up the deals. But at the same time I do think we need to know more about what’s going on,” Griffith said. “I’m a big believer in transparency and the more we know, the better job we can do as congressmen.”

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(Sandhya Raman contributed to this report.)

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