HR 5304

This bill, the PBM Transparency in Prescription Drug Costs Act, aims to increase transparency in how prescription drug costs are managed. It requires health plans and pharmacy benefit managers (PBMs) to report detailed pricing and utilization data to plan sponsors, including information on rebates received from drug manufacturers. Furthermore, the bill mandates that PBMs pass through all rebates to health plans and prohibits ‘spread pricing’ – charging plans more for drugs than they actually pay – while also requiring a pass-through of all drug manufacturer rebates to the health plan. The bill also seeks to ensure fair pricing practices and increase transparency regarding drug dispensing channels.