Lavern Spicer, Founder and Executive Director of Curley’s House of Style, Inc./Hope Relief Food Bank, has called for Congress to implement strong transparency reforms concerning Pharmacy Benefit Managers (PBMs) and the 340B Drug Pricing Program. “PBM opacity is driving up costs and denying care,” — a matter gaining traction in New York. Spicer made this statement on X, Nov 24.
“The three largest Pharmacy Benefit Managers control ~80% of the market,” said Spicer. “insurance giants and their PBM middlemen are cashing in hundreds of billions. PBM reform isn’t a partisan pipe dream – it’s the clearest, most achievable fix Congress can pass RIGHT NOW. Y’all in Washington keep talking about “affordability” but refuse to act.”
PBMs are currently under bipartisan scrutiny in Congress. Lawmakers are investigating opaque fees, rebate practices, and steering mechanisms that may contribute to increased patient costs. The Federal Trade Commission (FTC) is conducting an inquiry into pricing methods and reimbursement practices. Several bills have been proposed to enhance transparency and limit spread pricing. The three largest PBMs—CVS Caremark, Express Scripts, and OptumRx—dominate approximately 79% of the market.
The FTC’s second interim staff report released on January 14, 2025, highlights significant PBM markups on specialty generics used for conditions such as cancer and HIV. It describes how vertically integrated PBMs affect pricing and access through complex fee structures and affiliated pharmacy steering. These findings have reinforced calls to “shine a light” on hidden rebates and spread pricing that can increase costs for patients and payers.
New York’s Department of Financial Services said it reviewed annual PBM reports plus over 100 complaints from pharmacies and pharmacy associations in a single year about PBM conduct and practices, leading to proposed regulations that would **ban abusive contract terms that raise drug costs, stop preferential treatment of PBM-owned pharmacies, and tighten oversight of PBM audits and reimbursement practices.
Spicer founded Curley’s House of Style, Inc./Hope Relief Food Bank in August 2001 as a grassroots nonprofit organization serving low- to moderate-income families, seniors, at-risk youth, the homeless, veterans, and people with HIV/AIDS across Miami-Dade County. Her advocacy focuses on affordability and access to essential services.
