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Pharmacy benefit managers stories

Jun 27, 2026

States target pharmacy benefit managers in effort to lower prescription drug prices

Multiple U.S. states are implementing measures to regulate pharmacy benefit management companies that oversee prescription drug coverage for health insurers, as part of efforts to reduce medication costs for consumers.

Jun 27, 2026·2 sources
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May 13, 2026

Optum Rx Replaces Traditional PBM Model with Flat Fee-Based Structure

Optum Rx announced it will transition away from the traditional pharmacy benefit manager model to a flat service fee structure, with group purchasing fully converting to flat fees by end of 2027.

May 13, 2026·1 source
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Top claims

  • ▪A Louisiana law imposes an $11.81 dispensing fee on pharmacy benefit managers and mandates that they operate for the benefit of health-insurer clients and plan enrollees
  • ▪Lawmakers in at least 26 states introduced more than 120 bills targeting pharmacy benefit managers in 2026, with about a quarter of those bills clearing at least one legislative chamber
  • ▪Legislators in at least a dozen states passed laws in 2026 to limit compensation to pharmacy benefit managers, set minimum payments to pharmacists, and require more information disclosure

Subtopics

Drug Pricing and Access2Consumer protection1Healthcare Reform1Pharma1Pharmaceutical Industry1State-level AI regulation1US health policy & drug pricing1US healthcare regulation1

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