States ramped up efforts in 2025 to reform pharmacy benefit managers through new laws targeting ownership restrictions, transparency requirements, and compensation models that critics say harm independent pharmacies and obscure drug pricing. Arkansas made history by banning PBMs from owning pharmacies through House Bill 1150, though the law faces legal challenges and a preliminary injunction has temporarily blocked enforcement. Massachusetts enacted comprehensive PBM licensing and transparency requirements under Senate Bill 3012, mandating detailed reporting and oversight with implementation deadlines extending into 2026. Colorado and California both passed "delinking" laws that prohibit PBM compensation from being tied to drug prices, instead requiring flat-fee models to remove incentives for favoring expensive medications. Several states including Utah implemented r…

Louisiana and Indiana each introduced bills that would also prohibit PBM ownership of pharmacies, but neither bill contained that provision in their final versions. Massachusetts, on the other hand, pursued a different but equally impactful approach by enacting an expansive PBM licensing and transparency law (Senate Bill 3012). This comprehensive legislation mandates rigorous registration, detailed reporting, and robust oversight mechanisms for PBMs operating within the Commonwealth. The law includes a series of staggered implementation deadlines, extending into late 2025 and early 2026. Colorado introduced a significant structural change with the passage of its delinking law, House Bill 1094. This legislation fundamentally alters how PBMs are compensated, prohibiting their remuneration from being tied to the price of drugs. Instead, it transitions PBM compensation to…