Labor Department Tightens Scrutiny of Pharmacy Benefit Managers on Disclosing Who Funds Them

Pharmacy Benefit Managers (PBMs), the influential companies “that manage hundreds of billions of dollars” of U.S. pharmaceutical spending, will have to be more transparent about who funds them, according to an announcement on new disclosure rules by the Labor Department on Wednesday.

“The Trump administration will require the companies that manage hundreds of billions of dollars of drug spending to disclose details on how they get paid.”
https://t.co/LDCEkfTtGf

— Rapid Response 47 (@RapidResponse47) October 28, 2026

Here’s what is known so far about the upcoming changes, including when they start in 2027.

…[T]he U.S. Department of Labor announced new regulations requiring Pharmacy Benefit Managers (PBMs) to disclose detailed payment information from pharmaceutical companies to employers. This initiative aims to enhance transparency in the PBM sector, which has faced criticism for its opaque business practices that potentially inflate healthcare costs. 

[…]

The new regulations from the U.S. Department of Labor are set to take effect in July 2027 and are designed to improve transparency in the PBM industry. This sector has been under scrutiny for its lack of clarity regarding pricing and payment structures, which can lead to inflated healthcare costs for employers and consumers alike. By requiring PBMs to disclose actual drug prices and various payments received from drug manufacturers, employers will gain the ability to audit PBM practices and understand the rebates and profits derived from pricing discrepancies.

The Labor Department proposed the rules change back in January, writing in a release that its Employee Benefits Security Administration’s proposal is “designed to bring overdue transparency to the fees and compensation pharmacy benefit managers receive.” It added a simple explainer on the regulation:

PBMs act as an intermediary in the prescription drug supply chain for employer-sponsored self-insured group health plans that provide coverage to approximately 90 million Americans. Health plan fiduciaries, however, often cannot obtain full transparency into the payments that PBM service providers and their affiliates receive from drug manufacturers, pharmacies, and others.

The proposed rule would require pharmacy benefit managers to make disclosures to plan fiduciaries that would allow them to assess the reasonableness of compensation for the services and to fulfill their duties under the Employee Retirement Income Security Act. 

The release continued, hailing the regulation as “the most significant federal reform of prescription drug middlemen proposed in decades and builds on the accomplishments of the administration’s first term.” 

At the time, Deputy Secretary Keith Sonderling said:

“The Department of Labor is delivering on President Trump’s promise to fix a broken healthcare system by introducing radical transparency into drug costs.This action will allow employers to see the full extent of the fees charged by pharmacy benefit managers, enabling them to negotiate a better deal for themselves and American workers.”

RedState has previously written at length on the issue of PBMs failing to share who in the drug industry pays part of their representatives’ paychecks, while also getting paid by Americans’ employers. The opinions by conservatives and Republicans are mixed on the matter.

Earlier in October, my colleague Ben Smith wrote about another effort by the Trump administration to lower drug and healthcare costs for American families by requiring hospitals and insurance companies to tell consumers exactly what those entities are charged for prescription drugs.

Meanwhile, Congress continues to keep pushing for answers from the PBMs, as House Oversight Committee chair, Republican Rep. James Comer (KY-01), pressed in an X post late last week.

Pharmacy Benefit Managers are driving up our prescription drug prices with predatory tactics. It now appears PBMs are targeting our local pharmacies with punitive audits because they supported my bipartisan legislation to make life-saving drugs more affordable. I want answers👇🏻

— Rep. James Comer (@RepJamesComer) October 23, 2026

We’ll keep you posted.

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