What the Newest Landmark PBM Reform Means for the Pharmacy Industry

After many failed attempts and an unprecedented advocacy effort, the retail and community pharmacy industries have been celebrating the landmark pharmacy benefit manager reform (PBM) included in the Consolidated Appropriations Act of 2026 (HR 7148). Signed into law just this week, once the provisions take effect, the statute will give the Centers for Medicare & Medicaid Services (CMS) authority to more closely monitor PBM practices—specifically regarding contracting and delinking compensation.

“Reimbursing a pharmacy below their acquisition cost theoretically shouldn't fly any longer, nor should it be okay to pay a pharmacy exactly what it costs them to buy the drug. How could the pharmacy keep its lights on if it's not making any margin based on the cost of drugs when it's dispensing that product?” asked Jesse Dresser, Esq, partner in the Life Sciences Department and head of the Pharmacy Practice Group at Frier Levitt Attorneys at Law.

In this week’s episode of Over the Counter, Dresser joined Drug Topics to discuss the basis of the Trump Administration’s newest PBM reform. Through his exploration of historical context behind the pharmacy-PBM relationship, Dresser provided necessary nuance to the law’s provisions and how it will forever change the distribution of prescription drugs in the US.

Giving CMS the power to more closely oversee PBMs and their dealings with pharmacies, this legislation has the chance to rid the pharmacy industry of underwater reimbursements, unfair contracting, and more. Learn from a pharmacy law expert who has worked closely around HR 7148 as well as with the financial strife that has encapsulated community pharmacy throughout history.

Stay tuned for weekly podcast episodes of Over the Counter powered by Drug Topics. Check out our most recent episode with Alyssa Billingsley, PharmD, senior director of pharmacy content at GoodRx. She explored the evolving landscape of Rx-to-OTC switches and how they are significantly impacting pharmacists’ roles in their communities.

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