States Enact Dozens of Laws Regulating Pharmacy Benefit Managers

Legislators in at least a dozen states passed laws this year limiting compensation to pharmacy benefit managers, setting minimum payments to pharmacists, and requiring greater disclosure of information, The Washington Times reported Saturday. Lawmakers in 26 states introduced more than 120 bills on the topic, with about a quarter advancing through at least one chamber.

A Tennessee measure will prohibit pharmacy benefit managers from operating retail pharmacies beginning July 1, 2028.

Which runs 136 pharmacies in the state and 9,000 nationwide, filed a federal lawsuit seeking to block the requirement. The Washington Times reported that drug companies, PBMs and their allies have spent at least $24 million on broadcast and digital advertising opposing such measures since the start of 2025. CVS alone spent $4 million this year on ads against the Tennessee law.

A poll by the healthcare research nonprofit KFF found that adults were at least somewhat worried about affording prescriptions. About 4 in 10 said costs had led them within the prior year to take less than the prescribed dose, use over-the-counter substitutes, or skip filling prescriptions. CVS sued Arkansas last year after similar legislation passed there, and a federal judge blocked the law.

The company also settled three Louisiana lawsuits accusing it of unfair trade and deceptive practices in lobbying, agreeing to pay $45 million without admitting wrongdoing. “If PBMs already didn’t exist, you’d need to invent one,” said Prem Shah, president of the CVS Health group overseeing its pharmacy and PBM operations.