Under a forthcoming Labor Department rule, pharmacy benefit managers would need to tell their employer clients more about how they get paid, according to an Oct. 28 report from The Wall Street Journal.
The department is sharing more details Oct. 29. The Journal reported the regulation would take effect in July 2027 and span self-insured employers.
Under the rule, PBMs would need to tell employers upfront about expected compensation and give earnings updates every six months. PBMs will have to disclose rebates and other payments from drugmakers, including any that may lead to steering patients toward certain drugs. Disclosure requirements would also cover group purchasing organizations linked to PBMs. The companies would need to keep employers informed about “spread pricing,” when employers could pay more for a drug than the pharmacy is reimbursed, as well.
A Labor Department official told the Journal that the rule intends to help reduce healthcare costs, aligning with an April 2025 executive order.
PBMs have long been under scrutiny by regulators, federal lawmakers and states, particularly over concerns they may steer people to more expensive drugs. For example, the Federal Trade Commission has been working on settlements with major PBMs over allegations that they inflated insulin list prices.
Drug spending has contributed to mounting pressure on employer healthcare costs. According to Business Group on Health’s 2027 Employer Healthcare Strategy Survey, pharmacy makes up one-quarter of employer healthcare spending and was slated to rise 12% in 2026. Just under half of large employers said they get “sufficient” insight into rebates and other payments from drug manufacturers to their insurer, administrator or PBM, KFF found.
Amid critiques, some PBMs, including Cigna’s Express Scripts and CVS Caremark, have been rolling out price transparency initiatives.
The Labor Department first pitched regulation targeting PBMs in January but was met with PBM opposition as similar February legislation rolled out, according to the Journal. That law’s relevant provisions will mainly go into effect in 2028.
Becker’s has reached out to the Labor Department and will update this story if more information becomes available.
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