Pharmacy Benefit Manager

NASHP’s Center for State Rx Drug Pricing has developed model legislation that allows states to define new standards for pharmacy benefit manager (PBM) business practices. This model bill addresses PBMs’ fiduciary responsibilities and bans PBM gag clauses that prevent pharmacists from sharing lower cost drug options with consumers.

Pharmacy Benefit Manager Model Legislation: Model legislation states can use to oversee PBM business practices.

Pharmacy Benefit Manager Questions and Answers: Commonly asked questions and answers about PBMs’ role in the drug supply chain and NASHP’s model legislation.

How Legislation Helps States Shed Light on Pharmacy Benefit Manager Operations: This blog explores how states can use this model bill to license PBMs, ban gag clauses that prevent pharmacists from sharing lower-price drug options with consumers, and require more transparency into exactly who profits from rebates.

This chart compares pharmacy benefit manager (PBM) laws in 31 states. States took varied approaches to regulating PBMs in 2018. This chart details each state’s approach and how their laws compare with NASHP’s PBM model legislation.

NASHP’s Center for State Rx Drug Pricing develops model legislation to help states control rising prescription drug costs, and features the bills on its website. State officials interested in these model bills can request a legislator’s guide and additional background materials. Please contact Jennifer Reck to receive this state-only material.

NASHP is continuing to research state legislative and administrative actions to control pharmaceutical costs. Check the resources listed below for updated information.

Latest Resources