Three Republican back-benchers signaled their frustration with pharmacy benefit managers, with one asking whether the industry has become dominated by an unlawful monopoly.

Reps. Morgan Griffith (R-Va.), Buddy Carter (R-Ga.), and Larry Bucshon (R-Ind.) each cast a cold eye over PBMs at a hearing of the Health Subcommittee to the House Energy and Commerce Committee.

“This seems like a monopoly,” Griffith said, hearing that three PBMs control 80 percent of the market. “It looks like we’ve got the foxes in the hen house and we’re going to have to take some action.”

While Griffith was speaking, Carter gave a thumbs-up to a witness who had criticized the benefits managers. Bucshon, trained as a surgeon, used his time to blast the founding premise of the benefits management industry. “I don’t like restricted formularies and I particularly don’t like it when non-medical people restrict access to medicine from profits,” he said. “The incentives are just not aligned.”

Members of both parties have been critical of benefits managers, with some condemning them as “middle-men” who needlessly drive up the cost of drugs.