- Johnson & Johnson reported fourth-quarter earnings that met expectations, with revenue slightly exceeding estimates.
- A significant health care bill moving through Congress aims too revive pharmacy benefit manager (PBM) reform.
- The current proposals build on a previous deal reached in December 2024 that faced opposition from then President-elect Trump and Elon Musk.
WASHINGTON, 2026-01-21 16:53:00 – Congress is once again considering sweeping changes to health care policies, including long-sought reforms to pharmacy benefit managers (PBMs), as part of a larger bill funding the Department of Health and Human Services. The renewed push for PBM reform comes after a similar deal struck in December 2024 faltered following public criticism from then President-elect Trump and Elon Musk.
Johnson & Johnson Posts Solid Fourth Quarter
Johnson & Johnson kicked off the fourth-quarter earnings season with results largely in line with expectations. The company reported profits and revenue slightly above consensus estimates. Looking ahead to 2026, J&J provided an earnings range that aligns with current forecasts and a revenue projection that surpasses expectations. specific financial details are available here.
PBM Reform back on the Table
The new health care bill represents a second attempt to address PBM practices, which have drawn scrutiny for their impact on drug prices. The previous agreement, reached in December 2024, included provisions aimed at increasing transparency and lowering costs, but it quickly unraveled after facing opposition from prominent figures. The current proposals seek to build on those earlier efforts, potentially offering a path forward for meaningful PBM reform.
The details of the revived PBM reform provisions remain under discussion, but they are expected to focus on increasing transparency in drug pricing and limiting the ability of PBMs to steer patients toward higher-cost medications. The fate of the bill, and the PBM reforms it contains, will likely depend on continued negotiations and the political climate in the coming months.
What are PBMs and why are they controversial? Pharmacy benefit managers act as intermediaries between drug manufacturers, insurance plans, and pharmacies. Critics argue that their complex system of rebates and discounts lacks transparency and ultimately drives up costs for consumers. The initial December 2024 agreement, championed by bipartisan lawmakers, aimed to require PBMs to disclose more information about their pricing practices and the fees they receive. Who was involved? Key negotiators included Senators Maria Cantwell (D-WA) and Chuck Grassley (R-IA), along with representatives from the White House and major health insurance companies. How did it end? The deal collapsed after then President-elect Trump publicly criticized it as insufficient and Elon Musk voiced concerns about potential conflicts of interest within the PBM industry, influencing public opinion and ultimately leading to its withdrawal.
