FY26 budget bill provisions on Rx rebates and PBMs

A proposed FY26 budget bill dropped overnight, with provisions aimed at Rx rebates and PBM practices.

For employers, this is a step in the right direction. If a plan negotiates economic value in the prescription drug system, that value should benefit the plan and its participants.

But rebate transparency lags the Rx revenue model. Today, material economics flow through vertically integrated affiliates like GPOs and PSAOs, where payments tied to formulary access and utilization sit outside standard rebate reporting. Those dollars are still driven by plan activity, and won't be pulled in under the rebate pass throughs.

This proposal shows momentum, but would be better to capture the entire revenue cycle of profit extraction at the cost of patients and plan sponsors.