NACDS calls for continued momentum on PBM reform as House Subcommittee examines drug supply chain

ARLINGTON, Va. — The National Association of Chain Drug Stores (NACDS) submitted a statement for the record to the U.S. House Committee on Energy & Commerce Subcommittee on Health for that panel’s hearing on “Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain.”

The enactment last week of the most significant federal pharmacy benefit manager (PBM) reforms advanced to date marks a pivotal turning point in federal oversight of the drug supply chain. In its statement, NACDS highlighted the importance of ensuring these Medicare-focused reforms are implemented as Congress intended and emphasized that continued scrutiny and additional policy action will be necessary to address remaining gaps and evolving PBM practices.

“The fact that Congress has passed, and President Trump has signed, meaningful PBM reform reverses an alarming trend of reforms reaching the cusp of enactment — only to be blocked at the last minute not on the substance, but by unrelated political factors,” stated NACDS president and CEO Steven C. Anderson.

Anderson continued, “We extend to the Subcommittee and to the Congress sincere appreciation and recognition for enacting the most significant federal PBM reforms advanced to date, in the Consolidated Appropriations Act, 2026. This legislation, enacted just one week ago, includes priority Medicare reforms urged by NACDS and allied organizations. Now, it will be essential to translate this victory and momentum into continued vigilance and progress. Swift implementation consistent with Congressional intent is essential — and additional reforms are needed now, and no doubt will be needed in the future, to address remaining and emerging PBM tactics.”

As attention turns to implementation, early resistance from the PBM industry underscores why continued oversight is essential. Industry voices have already begun attempting to reframe the issue — declaring PBM reform “settled,” urging policymakers to shift focus elsewhere, and downplaying the real-world consequences of longstanding PBM practices.

“You already may have seen and heard some of the PBM rhetoric since the enactment of this first array of PBM reforms, including claims that no further reforms are needed at the federal nor state levels, that reforms raise rather than lower costs, and even that pharmaceutical manufacturers are to be blamed for convincing Congress of something other than the truth,” Anderson continued. “This rhetoric is as questionable as their operational tactics. Congress deserves credit and admiration for accomplishing meaningful reforms, and for recognizing that this campaign for PBM reform has advanced to a new and crucial phase, buoyed by success in claiming a long-overdue win for the American people. In addition, it is essential that state governments continue to legislate, implement, and enforce the aspects of PBM reform that is within their power. PBM reform is complex, and requires an all-branches and all-levels of government commitment.”

While the enactment of Medicare PBM reforms marks meaningful progress, the consequences of years of unchecked PBM practices remain real and measurable:

• An average of more than six pharmacies are now closing every day — and the pace is accelerating.
• Americans have lost approximately 8,000 of their pharmacies — 13 percent of locations — since 2018.
• The PBM industry doubled its revenues in the past decade and is projected to re-double this decade — approaching $800 billion by 2030.
• 97 percent of Americans expect steps to be taken to prevent pharmacy closures; 83 percent say they would be concerned if their local pharmacy were to close — a concern on par with losing their primary care physician and nearly equal to losing their nearest hospital.

NACDS emphasized in its statement that pharmacies remain the most accessible healthcare destinations in communities across America. That proximity to patients is an extraordinary asset for access and affordability — and it also means that when PBM pressures cascade through the drug supply chain, pharmacies and patients take the hardest hit. Stabilizing that access is essential to protecting community-based care and ensuring Americans can obtain the medications and services they depend on.

“We look forward to continuing to work with the Administration and with Congress to leverage the proven effectiveness, the unique professional capabilities, the unsurpassed accessibility, and time-honored trust of America’s pharmacists, pharmacy teams, and pharmacies,” Anderson said.