Trump Labor Department Finalizes PBM Fee-Disclosure Rule

The rule requires pharmacy benefit managers to reveal rebates, spread pricing and other compensation to large self-insured employer health plans beginning in July 2027.

The Trump administration finalized a rule on Thursday, October 29, 2026, requiring pharmacy benefit managers to give large self-insured employer health plans detailed information about how the companies are paid. The Labor Department says the disclosures will help employers compare contracts and determine how much prescription-drug spending is retained by their benefit manager or related businesses.

The regulation is scheduled to take effect in July 2027. It does not directly set the price of a prescription or guarantee a particular reduction at the pharmacy counter. Instead, it creates reporting and audit rights intended to make negotiations between employers and pharmacy benefit managers, commonly called PBMs, less opaque.

What PBMs will have to disclose

PBMs negotiate drug discounts, design formularies, contract with pharmacies and process prescription claims for health plans. Their compensation can come from several parts of the drug supply chain, making it difficult for an employer to see whether the financial terms favor the health plan, the PBM or an affiliated company.

Under the final rule, covered PBMs must disclose rebates and other payments received from drugmakers, pharmacies and related entities. The reporting also includes spread pricing, the difference retained when a health plan pays a PBM more for a medicine than the PBM reimburses the dispensing pharmacy. Financial relationships involving brokers and consultants must also be reported when they could create a conflict of interest.

The disclosures are required while a plan is negotiating or renewing a PBM contract and then every six months. Covered employers may audit the information once a year. Healthcare Dive reported that noncompliance could lead to financial penalties and possible invalidation of a contract.

Scope and projected effect

The Labor Department narrowed the final regulation to large self-insured group health plans and adjusted its timing and terminology to align with pharmacy-benefit provisions in the Consolidated Appropriations Act of 2026. Regulators said the two systems serve different purposes: the statute supplies retrospective information about spending and use, while the Labor rule gives plans information before and during contract negotiations.

The department projects that the rule will lower drug costs for employers and workers by $22 billion over ten years, according to Healthcare Dive. That figure is an agency estimate rather than a measured saving. Actual results will depend on how employers use the data, how PBMs alter their contracts and whether the regulation survives any legal challenge.

Employers support the rule; PBM group objects

Employer advocates welcomed access to information that they say is needed to evaluate vendors and enforce contract terms. Supporters argue that more comparable pricing and compensation data could make PBMs compete more aggressively for employer business.

The Pharmaceutical Care Management Association, the industry’s principal trade group, called the rule duplicative and burdensome. Its president, David Marin, said Congress had already required detailed PBM transparency and argued that another reporting system could weigh especially heavily on smaller companies. Industry groups also questioned the Labor Department’s legal authority during the rulemaking process.

The final rule is therefore a significant transparency requirement, but not a direct cap on PBM fees or medicine prices. Employers will gain more information and an audit mechanism beginning in 2027; whether those tools produce the administration’s projected savings will become clearer only after contracts are renegotiated under the new requirements.

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What PBMs will have to disclose

Scope and projected effect