,,ii  #aafth ,,congress  #ast ,session  
,s4 #aecb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #af1 #bjai
 ,mrs4 ,blackburn 7for herself and ,mr4 
,braun7 introduced the following bill2  
which was read twice and referred to the
 ,committee on ,health1 ,education1     
,labor1 and ,pensions  ,a ,,bill  ,to   
require the ,government ,accountability 
,office to study the role pharmaceutical
 benefit managers play in the           
pharmaceutical supply chain and provide 
,congress with appropriate policy       
recommendations1 and for other purposes4
  #a4 ,short title ,this ,act may be    
cited as the ,pharmacy ,benefit ,manager
 ,accountability ,study ,act of #bjai4  
#b4 ,,gao ,study ,not later than #a year
 after the date of enactment of this    
,act the ,comptroller ,general of the   
,united ,states shall submit to the     
,committee on ,finance and the          
,committee on ,health1 ,education1      
,labor1 and ,pensions of the ,senate and
 to the ,committee on ,ways and ,means  

and the ,committee on ,energy and       
,commerce of the ,house of              
,representatives a report that--  7#a7  
addresses1 at minimum-- 7,a7 the role   
that pharmacy benefit managers play in  
the pharmaceutical supply chain2  7,b7  
the state of competition among pharmacy 
benefit managers1 including the market  
share for the ,nation's #aj largest     
pharmacy benefit managers2  7,c7 the use
 of rebates and fees by pharmacy benefit
 managers1 including data for each of   
the #aj largest pharmacy benefit        
managers that reflects1 for each drug in
 the formulary of each such pharmacy    
benefit manager--  7i7 the amount of the
 rebate passed on to patients2  7ii7 the
 amount of the rebate passed on to      
payors2  7iii7 the amount of the rebate 
kept by the pharmacy benefit manager2   
and  7iv7 the role of fees charged by   
the pharmacy benefit manager2  7,d7     
whether pharmacy benefit managers       
structure their formularies in favor of 
high-rebate prescription drugs over     

lower-cost1 lower-rebate alternatives2  
7,e7 the average prior authorization    
approval time for each of the #aj       
largest pharmacy benefit managers2  7,f7
 factors affecting the use of step      
therapy in each of the #aj largest      
pharmacy benefit managers2 and  7,g7 the
 extent to which the price that pharmacy
 benefit managers charge payors1 such as
 the ,medicare program under title      
,,xxviii of the ,social ,security ,act  
7#db ,u4,s4,c4 #acie et seq471 ,state   
,medicaid programs under title ,,xix of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq471 the ,federal  
,employees ,health ,benefits ,program   
under chapter #hi of title #e1 ,united  
,states ,code1 or private payors1 for a 
drug is more than such pharmacy benefit 
managers pay the pharmacy for the drug2 
and  7#b7 provides recommendations for  
legislative action to lower the cost of 
prescription drugs for consumers and    
payors1 improve the efficiency of the   
pharmaceutical supply chain by lowering 

intermediary costs1 improve competition 
in pharmacy benefit management1 and     
provide transparency in pharmacy benefit
 management4