The DRUG Act would regulate pharmacy benefit managers, the companies that manage prescription drug benefits for health insurance plans, starting in 2026. The bill prohibits these managers from charging fees tied to drug prices, discounts, or rebates—instead allowing only flat dollar fees agreed to in writing. It also bars them from charging plans different amounts than they reimburse pharmacies for the same drugs, from paying independent pharmacies less than their own affiliated pharmacies, and from steering patients to their own pharmacies through higher out-of-pocket costs or other unfair practices. Pharmacy benefit managers that violate these rules would face civil penalties of ten thousand dollars per day. The legislation applies to employer health plans, individual insurance plans, and health plans covered under federal employee benefits, with enforcement shared among the Departments of Health and Human Services, Labor, and Treasury.
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