New federal rule requires drug intermediaries to disclose how they’re paid
The most interesting thing here is that both parties have been circling PBM transparency for years, and now it's actually landing as a rule. Employers and unions have complained for a long time that they can't tell whether the rebates and fees their PBMs collect are working for them or against them. A disclosure requirement doesn't fix pricing, but it does force the conversation into the open, and that alone shifts some power back to the people writing the checks.
I'd want to know how detailed the disclosures will be in practice. A rule can demand transparency, but if the format is so dense that plan sponsors need their own consultants to decode it, we've just moved the opacity one step down the line. Still, I think this is a reasonable step. It won't lower drug prices overnight, and it doesn't touch the underlying negotiation dynamics between manufacturers and PBMs. But sunlight tends to change behavior, and for employers who feel they've been flying blind, that's a start worth taking.