DOL Finalizes PBM Transparency Rule, Gaining Support from Employers and Pharmacy Groups

The U.S. Department of Labor’s Employee Benefits Security Administration announced a final rule Thursday that increases transparency for pharmacy benefit managers (PBMs). Employer and pharmacy advocacy groups have praised the measure as a step toward clearer pricing practices.

Under the final rule, PBMs and their affiliates must disclose fees, compensation, rebates from drug manufacturers, and payments recouped from pharmacies to self‑insured employers. The regulation also targets spread pricing by requiring disclosure when a plan pays more for a drug than the amount reimbursed to the pharmacy.

Employers gain the right to audit these disclosures and to seek additional relief if a PBM fails to meet its obligations. The Department projects that the rule could lower prescription drug costs for health plans by up to $22 billion over the next decade.

“This is a win for every American worker who has ever paid too much at the pharmacy counter,” said Secretary of Labor Keith Sonderling. “For years, PBMs have operated in the shadows, pocketing hidden fees while workers and employers were left in the dark.”

The rule follows earlier PBM reforms enacted in the Consolidated Appropriations Act of 2026, which decoupled PBM compensation from drug prices in Medicare Part D and mandated more detailed reporting to plan sponsors.

The ERISA Industry Committee (ERIC) endorsed the final rule, noting that it will bring much‑needed visibility into PBM operations. “Large employers pay for their workers’ prescriptions, but many can’t see how much of that money their PBM and any affiliated entity keeps,” said James Gelfand, ERIC’s president and CEO. “This rule changes that. Employers will be able to check the numbers, ask hard questions, and hold their vendors accountable.”

The National Community Pharmacists Association (NCPA) also welcomed the regulation. “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, NCPA’s senior vice president of policy and pharmacy affairs. “This new rule creates additional transparency for the first time.”

The Pharmaceutical Care Management Association, which represents PBMs, warned that the rule could increase costs for patients and place a disproportionate burden on smaller PBMs. “The Department has made modest efforts to harmonize the rule with the recently enacted federal law, but we are concerned it may have exceeded Congress’s intent and its own authority,” said David Marin, the group’s president and CEO. “Patients, employers, and unions will have no new meaningful transparency from this action, but prescription drug benefits will now be more expensive.”

Photo: OsakaWayne Studios, Getty Images

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