NCPA Applauds Department of Labor Final Rule on PBM Transparency Requirements

ALEXANDRIA, Va. (Oct. 29, 2026) – The National Community Pharmacists Association today cheered a new rule released by the U.S. Department of Labor’s Employee Benefits Security Administration that requires pharmacy benefit managers and their affiliated brokers and consultants to disclose the fees and compensation they receive.

“The employers who pay PBMs to administer their health plans have been kept in the dark for many years when it comes to these fees and other forms of compensation. This new rule creates additional transparency for the first time,” said Ronna Hauser, PharmD, NCPA’s senior vice president of policy and pharmacy affairs.

The new rule (Improving Transparency into Pharmacy Benefit Manager Fee Disclosure), released today by the DOL, complements provisions included in the Consolidated Appropriations Act of 2026 and follows an executive order by President Donald Trump, “Lowering Drug Prices Once Again Putting Americans First.” NCPA strongly supported both measures. The rule ensures that employers can see for the first time how PBMs are actually paid. Employers and their fiduciaries can now use that information to negotiate contracts and seek lower prescription drug costs for workers and their families. The rule is projected by the DOL to lower prescription drug costs by as much as $22 billion over 10 years.

NCPA attended the announcement today at the DOL, where Assistant Secretary Daniel Aronowitz told PBMs that “the jig is up.” He noted that prescription drugs are the fastest growing part of an employer’s health care coverage, and that due to misaligned and conflicting financial incentives, PBM revenues grow when insurance plans spend more. As an example, he cited a particular drug costing $5.25 at the pharmacy counter that is charged to the plan for $84 — 16 times the cost. “The patient at the counter needs more than rebates. She needs medicine she can afford,” he said.

The final rule also provides important compliance-assistance information for all service providers to employer-sponsored group health plans, which are now required to report fees and compensation to group health plan fiduciaries in initial plan and semi-annual disclosures. It also allows the plan fiduciaries to audit the accuracy of the PBM disclosures and provides additional relief for plan fiduciaries if a PBM fails to meet its obligations.

Issued under ERISA’s statutory service provider prohibited transaction exemption, the final rule requires PBMs to disclose the following information for the first time:

• Rebates and other payments from drug manufacturers, distributors, wholesalers, rebate aggregators, or other purchasing entities;
• Spread compensation that is received when the price paid by the plan for a prescription drug exceeds the amount reimbursed to the pharmacy;
• Payments recouped from pharmacies in connection with prescription drugs dispensed to plan participants, including copay clawbacks and any other retroactive adjustments;
• Inflation or price protection agreements; and
• Any other compensation reasonably expected to be received, that is not included in the categories above, functioning as a catch-all to make sure the entire payment picture is captured.