With Executive Order Issued, NACDS Urges Trump Administration to Deliver PBM Reform for Americans

The National Association of Chain Drug Stores (NACDS) is thanking President Donald Trump for his April 15, 2025, Executive Order, "Lowering Drug Prices by Once Again Putting Americans First."

NACDS President and CEO Steven C. Anderson said: "NACDS appreciates this Executive Order's additional scrutiny of the PBM middlemen and its focus on bringing about reforms needed desperately and immediately by the American people and by their trusted pharmacies. In two national media appearances within one week's time last December, President Trump stressed the need to confront the middlemen's abusive and self-enriching tactics, and seeing the Administration initiate further action within its first 100 days is great news. NACDS will continue to engage vigorously in the process of underscoring the problems of PBM tactics and detailing the solutions. Importantly, one critical step that the Administration can take right away is to direct the passage of - and sign into law - the sound reforms that are ready to go in the Congress and that have overwhelming support."

Anderson continued, "As NACDS declared in our recommendations to the Trump Administration - 'Four Wins to Make America Healthy Again' - it is time to stop the rip-off and to deliver PBM middleman reform. It is time to stop the dominant PBMs from inflating Americans' drug prices, from barring access to Americans' pharmacy of choice, and from forcing pharmacies out of business. The costs of inaction are soaring, with nearly four pharmacies closing every day and with hundreds of millions in patient savings unrealized since the end of last year."

The Executive Order identified PBM reform as a priority for President Trump dating to his first administration, noting that "reform efforts ensured that government-mandated discounts were passed through to patients instead of being retained by middlemen."

New policy contained in the Executive Order includes a section dedicated to "Reevaluating the Role of Middlemen." It states: "Within 90 days of the date of this order, the Assistant to the President for Domestic Policy, in coordination with the Secretary, the [Office of Management and Budget] Director, and the Assistant to the President for Economic Policy, shall provide recommendations to the President on how best to promote a more competitive, efficient, transparent, and resilient pharmaceutical value chain that delivers lower drug prices for Americans."

Another section - titled "Improving Transparency into Pharmacy Benefit Manager Fee Disclosure" - states: "Within 180 days of the date of this order, the Secretary of Labor shall propose regulations pursuant to section 408(b)(2)(B) of the Employee Retirement Income Security Act of 1974 to improve employer health plan fiduciary transparency into the direct and indirect compensation received by pharmacy benefit managers."