AN ACT CONCERNING PHARMACY BENEFITS MANAGER REFORM.

SB 446 prohibits pharmacy benefits managers (PBMs) from charging pharmacies post-transaction fees or clawbacks, requiring them to pass drug rebates directly to patients at checkout. It bans PBMs from tying their compensation to medication costs, charging for formulary placement, or favoring more expensive drugs over cheaper clinically appropriate alternatives. The bill also mandates that group purchasing organizations contracting with PBMs must be U.S.-incorporated and disclose all fees, while the Attorney General will enforce compliance and oversee PBM operations. This directly affects pharmacies, patients, and PBMs by restructuring how drug costs and rebates are handled in the state.