Pharmacy Benefit Manager Reform Act

This bill requires pharmacy benefit managers (PBMs) to provide detailed annual reports to health plan sponsors about drug pricing, spending, and rebates for plans covering large employers (50+ employees). It mandates full pass-through of rebates from drug manufacturers to health plans, prohibits PBMs from charging patients more than pharmacies are paid for drugs (spread pricing), and requires detailed reporting on drug costs, formulary decisions, and comparative pricing data between in-house and independent pharmacies. The reports must include information about drug spending, out-of-pocket costs for patients, wholesale acquisition costs, and pricing differences across pharmacy channels. These requirements apply to group health plans and health insurance issuers for plan years beginning in 2025, with some provisions for small employers as well.