MADISON, WI — The Pharmacy Society of Wisconsin (PSW) strongly echoes and amplifies the call for comprehensive pharmacy benefit manager (PBM) reform issued by former Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt. In a striking and unprecedented critique from the former leader of the PBM industry’s own trade association, Merritt warns that PBMs have evolved into powerful, vertically integrated entities that now distort — rather than deliver — cost savings for employers, insurers, and patients.
His article, “We Can’t Have Lower Insurance Premiums and Drug Costs Without Reforming PBMs,” highlights how opaque payment schemes, spread pricing, unpredictable fees, and conflicts of interest have become embedded in the system, driving up costs and limiting patient choice.
Merritt writes, “The modern PBM bears little resemblance to the cost-lowering intermediaries of the past. Today, a single insurer-owned PBM can act as wholesaler, mail-order pharmacy, specialty pharmacy, benefit designer and even a drug manufacturer. Vertical integration has given insurers end-to-end control — and end-to-end profit — over the pharmaceutical supply chain long before a medication ever reaches a patient.”
PSW agrees: this is a turning point. When the former chief advocate for PBMs calls for structural reform, policymakers should take notice — and take action.
Senate Bill 203 provides Wisconsin with a direct, meaningful opportunity to address these long-standing concerns. The bill strengthens oversight, curbs anticompetitive practices, prohibits harmful steering tactics, and ensures pharmacies can continue serving their communities. Most importantly, it restores transparency and accountability to a system that has operated in the shadows for far too long.
“Mark Merritt — the longtime voice of the PBM industry — is now sounding the alarm. His message is unmistakable: PBM reform is no longer controversial, it’s necessary,” said PSW CEO Sarah Sorum. “PSW stands with him, and with every Wisconsin patient, pharmacist, and pharmacy technician who has been harmed by opaque PBM practices. Passing SB 203 isn’t optional — it’s essential to lowering costs, protecting patient access, and keeping local pharmacies open.”
PSW urges Wisconsin lawmakers to advance SB 203 without delay and deliver the patient-focused reforms Wisconsin families deserve.
