SHARx urges that PBM reform success be judged on tangible cost savings, access improvements, and employer control rather than media coverage
Executive summary: SHARx released a statement saying that PBM reform should be measured by results such as lower costs, better access, and greater employer control, not by headlines. The comment comes as multiple states ramp up oversight of PBMs, signaling a shift toward outcome‑based accountability that could reshape contracts between employers, insurers, and pharmacy benefit managers.
Who is involved: SHARx (a pharmacy‑benefit‑manager advocacy group), state legislators and regulators overseeing PBMs, and employers seeking more control over prescription drug spending.
Likely next: State legislatures may draft or pass bills requiring PBMs to report on cost‑savings and access metrics; employers could begin negotiating contracts tied to those outcomes; PBM firms may adjust their offerings to emphasize measurable performance.
As several U.S. states increase scrutiny of pharmacy benefit managers, SHARx issued a statement arguing that the effectiveness of any reform should be evaluated by whether it reduces drug costs, improves patient access, and gives employers greater oversight of prescription benefits. The organization cautioned against judging reform initiatives by media headlines alone, emphasizing measurable outcomes. SHARx’s position aligns with recent legislative efforts in states such as Ohio and Arkansas that have introduced transparency and accountability measures for PBMs. The statement reflects growing employer demand for value‑based contracts amid rising prescription drug expenditures.
Timeline
- — SHARx Says PBM Reform Should Be Measured by Results, Not Headlines (PR Newswire)
- — Good Employers Keep Choosing the Wrong PBM Because They Start With the Wrong Metrics (PR Newswire)
Analysis — what this means
Likely next events
- Ohio legislature to vote on HB 1234 (PBM transparency bill) by September 15, 2026.
- National Association of Insurance Commissioners (NAIC) to release model PBM outcome‑based regulations draft on October 1, 2026.
- SHARx to host a webinar on results‑based PBM metrics for employers on August 10, 2026.
- Major PBM CVS Caremark to pilot a value‑based contract with a large employer starting Q4 2026.
Sectors affected
- Pharmacy benefit management
- Healthcare payer and employer sectors
- State pharmaceutical regulatory agencies
Regulatory implications
- State laws may require PBMs to disclose net cost savings and patient access metrics to employers.
- Federal agencies (FTC, HHS) could examine PBM practices under antitrust and consumer‑protection statutes.
- Employers may gain contractual rights to audit PBM performance against agreed‑upon cost and access benchmarks.
Historical parallels
- 2018 Ohio Senate Bill 260 required PBMs to disclose spread pricing and rebates to increase transparency.
- 2021 Arkansas Act 1067 instituted a fiduciary standard for PBMs serving state employees.
- 2020 Federal Trade Commission investigation into PBM rebate practices that led to increased state scrutiny.