ARLINGTON, V.A. — FMI, The Food Industry Association, is urging Congress to move beyond limited transparency measures and enact comprehensive pharmacy benefit manager reform, warning that failure to do so threatens the viability of supermarket pharmacies and patient access to care in communities nationwide.
In a statement released Thursday, FMI Chief Public Policy Officer Jennifer Hatcher said meaningful reform must address three core issues: transparency, fair pharmacy reimbursement, and an end to PBM spread pricing. Spread pricing allows PBMs to charge health plans more for a drug than they reimburse pharmacies, keeping the difference.
FMI members operate approximately 12,000 supermarket pharmacies across the United States. According to Hatcher, rising prescription volumes have not translated into improved financial performance because reimbursement rates continue to decline.
Data from an FMI survey conducted earlier this year highlights the pressure on the sector. Nearly three-quarters of supermarket pharmacy businesses reported they were not profitable or only marginally profitable in 2025. More than one-third said pharmacies are at risk of closing within the next two years, and 70 percent reported closing at least one location over the past two years.
“Reimbursement is falling faster than volume is growing, and the math no longer works,” Hatcher said. “Addressing the root causes of pharmacy closures and rising drug prices requires more than transparency alone.”
FMI highlighted that the pharmacy community agrees on the need for reform and that it should address all three aspects simultaneously. Without progress on reimbursement and spread pricing, the association warned, PBM reform efforts will be incomplete, and patients will have fewer pharmacy choices.
FMI urges lawmakers to adopt comprehensive legislation that guarantees fair reimbursement, bans spread pricing, and boosts transparency to maintain pharmacy operations and ensure access to care.
