Whenever lawmakers begin discussing Pharmacy Benefit Manager (PBM) reform, a familiar pattern emerges: new advocacy groups, often with vague or positive-sounding names, suddenly appear to shape the debate. Groups like "Conservatives for Lower Health Care Costs" and "Arkansas Families for Affordable Healthcare" have recently entered the conversation, raising questions about their origins and affiliations. These organizations frequently oppose PBM reform efforts, arguing that such policies would lead to higher drug costs and disrupt market-based solutions.
One of the defining characteristics of these organizations is the lack of transparency surrounding their funding. While they claim to represent consumers or conservative values, their messaging often aligns closely with the interests of PBMs and major insurance companies. In most cases, these shadow groups do not publicly disclose their donors - making it difficult to determine who is really behind their advocacy efforts. However, their policy positions and media campaigns suggest significant backing from industry players seeking to maintain the status quo.
Beyond the emergence of these shadow groups, another pattern becomes evident: a wave of op-eds, social media posts, and influencer endorsements pushing the same talking points. This is no coincidence. Well-funded industry groups strategically invest in media campaigns to sway public opinion. Influencers, journalists, and policy experts are often compensated—directly or indirectly—to amplify anti-reform narratives across social and news media outlets.
For example, an influencer may post a video warning about the so-called "dangers" of PBM reform, while a think tank releases a study with similar conclusions. Simultaneously, op-eds appear in major newspapers, echoing these concerns. The goal is to create the illusion of widespread, grassroots opposition to reform when, in reality, the message originates from a small group of well-funded stakeholders.
Coordinated efforts like these are designed to stall or weaken PBM reform initiatives by sowing doubt among lawmakers and the public. When confronted with what appears to be broad opposition, policymakers may hesitate to push forward with legislation, fearing backlash or unintended consequences. In some cases, these efforts succeed in watering down reform measures, ensuring that PBMs and their corporate allies retain their market power.
The rise of groups like "Conservatives for Lower Health Care Costs" and "Arkansas Families for Affordable Healthcare" highlights the sophisticated strategies used to shape health policy debates. By funding shadow organizations and deploying paid media campaigns, industry players can manufacture “public” resistance to reforms that could disrupt their corporate profits. As PBM reform continues to be a hot-button issue, it is essential to scrutinize the sources of opposition and demand transparency in both advocacy and healthcare.
The best way to counter these deceptive tactics is with undeniable proof. If you are a pharmacy owner or healthcare provider impacted by underwater reimbursements and unsustainable PBM practices, bring your own receipts. Show lawmakers the real numbers—claims paid at a loss, annual totals for lost revenue, the number of patients you serve, and those you have been forced to turn away. What shines light into these shadows is the evidence we can provide - making it impossible to ignore the devastating effects of PBM abuse. Transparency and firsthand testimony are powerful tools in the fight for real reform. Stand up, speak out, demand accountability, and remember, a bright light erases shadows lurking in darkness.
Brandi Chane
PUTT Executive Board