Industry News and Headlines

How PBM Reforms Could Push Drugmakers Into the Pricing Spotlight

The Consolidated Appropriations Act of 2026 bans pharmacy benefit managers (PBMs) from receiving compensation tied to drug list prices and mandates 100% rebate pass‑through to plan sponsors by August 2028. The law also allocates roughly $190 million to the Centers for Medicare and Medicaid Services to enforce compliance and audit fee structures. With PBMs’ rebate‑driven leverage curbed, drug manufacturers will be forced to justify their list prices and renegotiate contracts on a true value‑pricing basis. The reforms dovetail with the Inflation Reduction Act to push the industry toward value‑based pricing.