WASHINGTON, D.C. — Patients Rising issued the following statement after President Trump signed into law new federal reforms addressing pharmacy benefit managers (PBMs) as part of the Consolidated Appropriations Act, 2026.

The legislation represents one of the most significant federal efforts to date to increase oversight and transparency in the prescription drug supply chain. PBMs act as intermediaries between drug manufacturers, insurers, employers, and pharmacies, and their business practices have faced increasing scrutiny from policymakers concerned about rising prescription drug costs.

The new law includes several provisions aimed at improving transparency and accountability in how PBMs operate. Among other reforms, the legislation:

• Delinks PBM compensation from the price of a drug in Medicare Part D, requiring PBMs to be paid through flat “bona fide service fees” rather than compensation tied to drug prices or rebates beginning in 2028.
• Requires PBMs to pass through 100 percent of rebates and discounts to employer health plans regulated under ERISA.
• Establishes new transparency and reporting requirements so employer health plans and Medicare Part D plan sponsors receive detailed information about drug pricing, utilization, and PBM compensation.
• Strengthens federal oversight of PBM business practices, including reporting requirements to the Department of Health and Human Services.
• Reinforces pharmacy access protections for Medicare beneficiaries through “any willing pharmacy” standards.

“Patients have waited far too long for Washington to confront opaque PBM practices that can inflate costs and distort access to medicine,” said Terry Wilcox, Co-Founder and Chief Mission Officer of Patients Rising. “Requiring greater transparency, delinking PBM compensation from drug prices, and ensuring employer plans receive the full value of negotiated rebates are important steps toward a system where the financial incentives in the prescription drug supply chain are better aligned with patients.”

In addition to the new law, federal regulators have also increased scrutiny of PBM practices. In February 2026, the Federal Trade Commission announced a settlement with Express Scripts addressing business practices related to insulin pricing and requiring changes aimed at improving transparency and aligning patient out-of-pocket costs with net drug prices.

While these actions represent meaningful progress, the ultimate measure of success will be whether patients experience lower out-of-pocket costs and improved access to the medicines they need.

Patients Rising will continue advocating for policies that increase transparency across the healthcare system, strengthen accountability among healthcare middlemen, and ensure that prescription drug savings reach the patients who depend on them.