The Trump administration has locked in a regulation that will require pharmacy benefit managers to disclose fees and compensation to self-funded employers.

The rule, finalized by the Department of Labor's Employee Benefits Security Administration, aims to ensure that employers can see what drug manufacturers, pharmacies and other entities are paying their PBMs and any affiliated brokers and consultants.

The department said in an announcement that this data will support employers in negotiating contracts and pushing to lower drug costs for their workers and their dependents.

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

Under the rule, PBMs must disclose several key sources of compensation, including manufacturer rebates, any compensation when the price for a drug paid by the plan exceeds reimbursement to the pharmacy and any payments recouped from pharmacies for dispensed drugs.

The rule was first proposed in late January, and while it enjoys support with employer groups, pharmacy benefit managers have pushed back on the changes.

The Pharmaceutical Care Management Association, the leading lobbying organization for PBMs, in March called for the agency to rescind the proposed rule, as after it was unveiled, lawmakers passed industry reforms as part of a bipartisan health funding package.

Those congressional PBM reforms include multiple provisions around transparency, and PCMA argued that the DOL rule would create duplicative reporting and disclosure requirements for these companies to navigate.

Source link