PBM Accountability Project Led 75+ Organizations in Support of DOL’s PBM Transparency Rule

Ahead of the U.S. Department of Labor’s review of its proposed rule, Improving Transparency into Pharmacy Benefit Manager Fee Disclosure, the PBM Accountability Project led a coalition of national organizations in sending a letter to Secretary Lori Chavez-DeRemer applauding the Department’s leadership in advancing long-overdue, common-sense guardrails to rein in the unchecked influence of PBMs over employer-sponsored prescription drug benefits. 

“We have seen undeniable evidence that pharmacy benefit managers (PBMs) and their parent corporate insurers have leveraged market consolidation and vertical integration to accumulate outsized power in the healthcare and prescription drug marketplace. In doing so, they have constructed self-reinforcing pricing structures that inflate drug costs, penalize or restrict cost-saving practices, and undermine patient choice and access. The inclusion of PBM reform components in the Consolidated Appropriation Act of 2026, the Federal Trade Commission’s recent consent decree with Express Scripts over insulin pricing, and the FTC’s earlier documentation of PBM price manipulations should be considered positive first steps to much needed reforms and make clear the desire in the public policy sphere to fix this broken system. The DOL proposed rule is a critical component in this effort.  

We are concerned, however, that PBMs will exploit any loophole, as they have many times in the past, to avoid necessary disclosures under the proposed rule. Investigative reporting has already revealed that the largest PBMs have established offshore subsidiaries known as group purchasing organizations (GPOs) to collect fees from drug manufacturers on top of the rebates negotiated by PBMs. By adding this additional layer of complexity, PBMs – and the insurance companies that own them – obscure how much money truly flows through their vertically integrated companies and avoid passing savings through to health plans as intended.” 

Read the full letter here.