As Reform Efforts Persisted, PBM Trade Association Set Its Lobbying Record in 2023

The pharmaceutical and health products industry, which has consistently outspent all other industries on federal campaign contributions and lobbying, spent nearly $378.6 million in 2023 to further policy goals, according to data compiled by OpenSecrets.

With the 2024 presidential election around the corner, the pharma/health products industry nearly evenly distributed their donated campaign funds to Democratic and Republican lawmakers during the 2023-2024 election cycle. Among the 20 lawmakers who received the most contributions from the industry, nine are Democrats. President Joe Biden, who is running for re-election this year, topped the list, receiving over $232,000.

The Pharmaceutical Research and Manufacturers of America (PhRMA) spent $27.6 million in 2023, ranking as the top individual lobbying spender in the pharmaceutical industry and the third-largest lobbying spender in the health care sector, according to data compiled by OpenSecrets. The trade association lobbied aggressively against the Pharmacy Benefit Manager Transparency Act of 2023 (S. 127), which was sponsored by Sens. Maria Cantwell (D-Wash.) and Chuck Grassley (R-Iowa) and reintroduced in the 118th Congress. The bill aims to eliminate spread pricing and prohibit pharmacy clawbacks.

The Pharmaceutical Care Management Association (PCMA), an organization representing PBMs, spent a record $15.4 million in lobbying in 2023, nearly doubling the amount it spent in 2022. That made the association the second-largest individual lobbying spender in the pharmaceutical industry. The organization also hired more lobbyists in 2023, with 11 of its 15 registered lobbyists previously holding jobs in the federal government. One of the lobbyists, former Rep. Ryan Costello (R-Pa.), once served as a member of the House Energy and Commerce Committee and joined PCMA just before a Senate panel approved a legislative package aimed at boosting the transparency of PBM business practices in July 2023. Meanwhile, the group has launched several digital advertising campaigns to criticize “Big Pharma’s egregious pricing and anti-competitive practices” and oppose legislation that “delinks” PBM payment from drug list prices and utilization in Medicare Part D.

Lobbying spending among several major pharmaceutical companies also reached a record high in 2023. Amgen Inc. invested almost $14.3 million in lobbying, a 41% jump from 2022. The Biotechnology Innovation Organization decreased its lobbying spending by 32% compared with the previous year, as Pfizer Inc. and AbbVie, Inc. both left the trade group. AbbVie also notably parted ways with PhRMA.

As bipartisan interest in changing PBM practices and lowering drug costs also persisted at the state level, the pharma industry has beefed up its influence on state-level officials and hired firms that specialize solely in state-level advocacy. According to, which compiled 19 states’ lobbying data, the pharma/health products industry continued to be a top spender at the state level in 2023. PhRMA spent over $2.5 million on lobbying in 12 states, followed by Pfizer with nearly $1.0 million spent in 14 states.

This infographic was reprinted from AIS Health’s biweekly publication Radar on Drug Benefits.

© 2024 MMIT
Jinghong Chen

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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