NCPA applauds new PBM disclosure rule

ALEXANDRIA, Va. – The National Community Pharmacists Association (NCPA) supports a new rule released by the U.S. Department of Labor’s Employee Benefits Security Administration that requires pharmacy benefit managers (PBMs) and their affiliated brokers and consultants to disclose the fees and compensation they receive. “The employers who pay PBMs to administer their health plans have been kept in the dark for many years when it comes to these fees and other forms of compensation,” said Ronna Hauser, PharmD, NCPA’s senior vice president of policy and pharmacy affairs. “This new rule creates additional transparency for the first time.” The new rule – “Improving Transparency into Pharmacy Benefit Manager Fee Disclosure” – complements provisions included in the Consolidated Appropriations Act of 2026 and follows an executive order by President Donald Trump, “Lowering Drug Prices Once Again Putting Americans First.” NCPA strongly supported both measures. The rule ensures that employers can see for the first time how PBMs are actually paid. Employers and their fiduciaries can now use that information to negotiate contracts and seek lower prescription drug costs for workers and their families. The rule is projected by the DOL to lower prescription drug costs by as much as $22 billion over 10 years. Issued under ERISA’s statutory service provider prohibited transaction exemption, the rule requires PBMs to disclose the following information for the first time:

• Rebates and other payments from drug manufacturers, distributors, wholesalers, rebate aggregators or other purchasing entities;
• Spread compensation that is received when the price paid by the plan for a prescription drug exceeds the amount reimbursed to the pharmacy;
• Payments recouped from pharmacies in connection with prescription drugs dispensed to plan participants, including copay clawbacks and any other retroactive adjustments;
• Inflation or price protection agreements; and
• Any other compensation reasonably expected to be received, that is not included in the categories above, functioning as a catch-all to make sure the entire payment picture is captured.