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Federal Register · Regulatory notice

Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure

The Department is issuing a final regulation that will require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of large, self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). Pharmacy spending is a major driver of overall healthcare costs for employers and is growing faster than medical and surgical spending. These disclosure requirements apply for purposes of ERISA's statutory prohibited transaction exemption for service arrangements under section 408(b)(2). These disclosures are needed so that fiduciaries can assess the reasonableness of contracts or arrangements with these service providers, including the reasonableness of the service providers' compensation. As directed in section 12 of President Trump's Executive Order 14273, Lowering Drug Prices by Once Again Putting Americans First, the Department is issuing this rule to improve employer health plan transparency into the direct and indirect compensation received by pharmacy benefit managers. This final rule will affect sponsors and other fiduciaries of large, self-insured group health plans and certain service providers to such plans.

Follow CVS
Became public
Nov 2, 2026
Event / period date
Jan 4, 2027
Collected
Nov 8, 2026, 7:42 PM EST

Why this is connected

The source explicitly mentions CVS HEALTH Corp. A mention alone does not establish a financial benefit.

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Source evidence

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prescriptions.\361\ Utilizing the stated price elasticity, estimated price decrease, and prescription demand, the Department estimates that approximately 1.34 million additional prescription drugs will be purchased as a result of lower prices.\362\ Given an average WTP of $218 per prescription, the Department estimates that the value of the gross willingness to pay would result in up to $293.0 million of benefits annually.\363\ The $218 WTP includes not just consumers' but also insurers' portion of drug spending, reflecting an assumption that insurance markets capture pharmaceutical value, with such value taking various forms, including health improvements for consumers/patients and reduced non-adherence-related medical costs (with associated savings accruing to a combination of newly-adherent patients, premium-payers generally, and insurance companies).\364\ --------------------------------------------------------------------------- \361\ Abe Dunn, Health Insurance and the Demand for Medical Care: Instrumental Variable Estimates Using Health Insurer Claims Data, Journal of Health Economics, Vol. 48 (2016). \362\ This estimate is calculated as: -1 percent price reduction x -0.358 price elasticity x 375,465,168 prescriptions = 1,344,165 prescriptions. \363\ This estimate is calculated as: $217.98 average prescription WTP x 1,344,165 prescriptions = $293,001,152. \364\ Insurance

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