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Enhanced Transparency for Pharmacy Benefit Managers: New Rules for Drug Pricing

New regulations aim to increase transparency in the operations of Pharmacy Benefit Managers (PBMs) that negotiate drug prices. This will give citizens and insurance plans better insight into how much money PBMs receive from drug manufacturers and how much of that is passed back to the plans. These changes could potentially impact drug costs and healthcare benefits, making them more understandable.
Key points
Pharmacy Benefit Managers (PBMs) will be required to disclose more information about their revenues and fees related to prescription drugs.
PBMs must report how much money they receive from pharmaceutical manufacturers and what percentage of these funds is passed through to health plans.
The government will publish annual reports summarizing this data, increasing public oversight of the drug market.
The changes will take effect from January 1, 2027, allowing time for adaptation to the new requirements.
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Additional Information
To amend title XI of the Social Security Act to enhance pharmacy benefit manager transparency requirements.
Print number: HR 7717
Sponsor: Rep. Gallego, Ruben [D-AZ-3]
Process start date: 2024-03-19