New PBM Pricing Disclosure Rule to Aid Employers in 2027
Self-insured businesses will gain access to audit PBMs and review previously hidden rebates starting in July 2027.
Updated on Oct. 28, 2026 in Healthcare
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Should the government mandate that pharmacy benefit managers disclose their drug pricing and revenue data?
The U.S. Labor Department issued a new rule requiring pharmacy benefit managers (PBMs) to disclose revenue and pricing data to self-insured employer clients. The regulation, which takes effect in July 2027, mandates reporting of rebates and payments from drugmakers and pharmacies.
Why it matters
By requiring transparency in spread pricing and compensation, the regulation aims to lower healthcare costs for employers who fund their own health plans. This shift forces PBMs to disclose previously opaque revenue streams, fundamentally altering how self-insured businesses manage their pharmacy benefits.
Pharmacy benefit managers must report actual earnings to self-insured employers every six months under the new mandate. This reporting requirement covers all rebates and payments collected from pharmacies and drug manufacturers, with compliance set to begin in July 2027.
The players
Labor Department
A federal executive agency responsible for protecting the health and welfare of workers and overseeing the administration of self-insured benefit plans.
The details
The rule mandates that PBMs disclose expected compensation upfront, including payments collected through affiliated group purchasing organizations. Self-insured employers gain the right to audit PBM operations to verify the accuracy of these financial disclosures. This mechanism is designed to eliminate spread pricing practices where PBMs retain the difference between what they charge an employer and what they pay a pharmacy.
Timeline
February 2026: Congress passed a separate law regarding prescription drug transparency.
July 2027: The Labor Department regulation takes effect.
2028: Most provisions of the separate congressional transparency law take effect.
Market Landscape
This regulation complements the transparency framework established by the February 2026 congressional law regarding prescription drug rebates. It marks a shift toward federal oversight of PBM operations to align with broader healthcare cost-containment efforts.
Self-insured employers should prepare to audit their pharmacy benefit contracts to ensure compliance with the new disclosure requirements starting in mid-2027. Businesses should coordinate with legal counsel to update service agreements with their PBMs to include mandated audit access.
The takeaway
The rule introduces essential visibility into pharmacy benefit pricing, providing employers with the data necessary to challenge hidden fees and spread pricing. Operations managers should use the time before July 2027 to review current PBM contracts and clarify audit rights in anticipation of the new disclosure standards.
Further reading
Find more analysis on regulatory shifts in the Healthcare section.
Source note: This article includes information reported by Baton Rouge Business Report.
Live Poll
Should the government mandate that pharmacy benefit managers disclose their drug pricing and revenue data?
