New federal rule will require prescription drug middlemen to share secret payments data
A final rule requires pharmacy benefit managers serving large self-insured employer plans to disclose how they are paid.
TL;DR
- The U.S. Department of Labor finalized a compensation-disclosure rule for pharmacy benefit managers serving large self-insured employer health plans.
- Required information includes manufacturer rebates, spread pricing and potential conflicts of interest.
- The requirements apply to plan years beginning on or after July 1, 2027, and a PBM trade group opposes the rule.
The U.S. Department of Labor finalized a rule requiring pharmacy benefit managers (PBMs) to disclose compensation to large, self-insured employer health plans. STAT reported that the disclosures cover payments from drugmakers and other entities. [1] [2]
The information includes manufacturer rebates, spread pricing and relationships with brokers and consultants that may create conflicts of interest. The Plan Sponsor Council of America (PSCA) and The Washington Post reported that the rule calls for initial and ongoing disclosures. [2] [3]
The rule also gives plans the right to audit the disclosures. Its requirements apply to plan years beginning on or after July 1, 2027, according to PSCA. [2]
The PBM trade group PCMA argued that the requirements duplicate existing law and burden smaller PBMs, The Washington Post reported. Whether the added disclosures produce the savings federal officials project remains open. [3]
Why it matters
Large employer plans are set to gain more information about the compensation of companies that manage prescription drug benefits. The effect on drug spending and competition remains to be established.
Editor's note
STAT’s report is partially paywalled; its accessible text and two independently written reports support the rule’s principal features. Claims about savings and burdens are projections or stakeholder views. The linked Labor Department rule PDF returned 403 during review.