Under spread-pricing arrangements, PBMs charge one amount to health plans for a drug, then reimburse pharmacies a different, often lower amount–and capture the spread in between. (Photo: Shutterstock)

Two U.S. senators have asked the inspector general of the Health and Human Services Department to investigate a practice by pharmacy-benefit managers known as spread pricing, as part of a wider inquiry by lawmakers into U.S. drug costs.

Ron Wyden of Oregon, the ranking Democrat on the Senate Finance Committee, said that he and Chairman Chuck Grassley of Iowa have requested the inspector general, which examines the operations of government health programs, to probe the issue. Under spread-pricing arrangements, PBMs charge one amount to health plans for a drug, then reimburse pharmacies a different, often lower amount–and capture the spread in between.

“PBMs are paying one set price to pharmacies for a particular drug, but they're turning around and charging Medicaid and other health-care payers far more for that same prescription,” Wyden said in his opening remarks at a hearing Tuesday. “If there are changes that can be made to clamp down on this exploitation of Medicaid, I hope the committee will consider it. In my view, it's as clear a middleman ripoff as you're going to find.”