45 state attorneys general back PBM transparency

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A coalition of 45 state attorneys general have urged the U.S. Department of Labor to strengthen transparency requirements for pharmacy benefit managers.

The group backed a proposed rule requiring PBMs to disclose detailed fee and revenue information to employer-sponsored health plans governed under the Employee Retirement Income Security Act, according to an April 15 open letter.

The attorneys general said PBMs play a central role in the drug supply chain and currently manage approximately 80% of prescription drug claims, raising concerns about market concentration and limited visibility into pricing practices.

The letter also called on the department to clarify that the federal rule would not preempt existing state PBM transparency laws and to support coordination with state enforcement efforts.

The coalition said stronger disclosure requirements would help employers and regulators better understand drug spending and ensure PBMs are complying with state and federal laws.

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