The CEOs of the three top insulin manufacturers — Eli Lilly, Sanofi and Novo Nordisk — as well as executives from top pharmacy benefit managers (PBM) were in the hot seat Wednesday.

The PBMs pointed fingers at the drug companies, who in return blamed the PBMs.

For their part, senators indicated a desire to change the entire system, with the hearing also previewing a debate on Thursday about bills targeting PBMs.

“Americans die, get sicker than they should and go bankrupt because they cannot afford the outrageous cost of prescription drugs, while the drug companies and the PBMs make huge profits. That has got to change and this committee is going to do everything possible to bring about that change,” Senate Health, Education, Labor & Pensions (HELP) Committee Chairman Bernie Sanders (I-Vt.) said. 

Both parties and chambers seem to have common ground with legislation aimed at reforming the PBM industry, though Sanders noted that the “very modest” bills the committee will consider Thursday are not the end of his efforts.

“I kinda feel like Hell’s freezing over because chairman Sanders and I actually agree on something, and it’s that something needs to be done with PBMs,” Sen. Markwayne Mullin (R-Okla.) said. 

The committee on Thursday will try again to amend and advance bills aimed at increasing competition for generic drugs, increasing access to medicine for rare diseases, as well as changing PBM business practices.

The panel met last week to consider the same slate of seemingly bipartisan bills, but the hearing was held up over internal process complaints and eventually postponed for a week.