NCPA has submitted a letter to the secretary of the U.S. Department of Labor (DOL) asking the DOL to regulate PBM compensation practices under the Employee Retirement Income Security Act of 1974. This is a longtime ask from NCPA. DOL's actions in this space have recently resurfaced based on President Trump's Executive Order issued on April 15, 2025, Lowering Drug Prices by Once Again Putting Americans First, which tasked the DOL with implementing measures to reduce prescription drug costs.
NCPA's requests include the following:
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Require full transparency from PBMs in their dealings with ERISA-covered plans, including clear disclosures of pricing structures, rebates, and compensation arrangements.
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Establish safeguards against excessive PBM compensation, particularly by limiting such compensation to bona fide service fees.
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Define acceptable compensation standards that separate PBM revenue from drug list prices—for example, banning percentage-based fees that scale with drug list prices.
NCPA is tracking the DOL's activity closely and will report out to members as we learn more.
