AG Brown Backs Coalition for Drug Pricing Transparency

Attorney General Brown Joins Bipartisan Coalition in Support of Federal Rule to Increase Transparency in Prescription Drug Pricing

Published: 4/16/2026

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FOR IMMEDIATE RELEASE

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Comment letter supports stronger disclosure requirements for PBMs, seeks clarity that proposed rule doesn’t preempt state PBM transparency laws

BALTIMORE, MD — Attorney General Anthony G. Brown joined a bipartisan coalition of 44 attorneys general in submitting a comment letter supporting a proposed U.S. Department of Labor (Department) rule that would require greater transparency from pharmacy benefit managers (PBMs) that service employer-funded health plans covered under the Employee Retirement Income Security Act of 1974 (ERISA).

Created in the late 1960s to process prescription drug claims, PBMs now play a far broader and more powerful role in the health care system by managing prescription drug benefits for health insurers. This includes, among other things, negotiating rebates and reimbursements with drug manufacturers and determining which drugs are covered and at what cost. Approximately 136 million Americans receive health coverage through an employer — either their own job or a family member’s — and the proposed rule responds to concerns that there often is little visibility into how PBMs are making money or why drug costs change. It would require PBMs to disclose twice a year how they generate revenue and would give employers the right to audit them. PBMs have also long sought to avoid state regulation by claiming federal preemption under ERISA. The attorneys general urge the Department to clarify that the proposed rule does not preempt state PBM transparency laws.

Further, in the comment letter, the attorneys general ask the Department to clarify that it supports working with them to enforce the rule. According to the coalition, there should be mention that nothing in the rule is intended to prevent the Department from referring matters to state attorneys general, requesting their investigative or enforcement assistance, or coordinating with them when the Department discovers violations of state law.

Today, the top three PBMs manage approximately 80% of prescription drug claims. Due to the power imbalance held by PBMs and the negative effects of such power on drug pricing, all 50 states, the District of Columbia, and Puerto Rico have enacted laws to rein them in. Maryland has enacted transparency requirements and prohibits PBMs from paying independent pharmacies less than the amount that they pay pharmacies owned by the PBM.

In submitting the comment letter, Attorney General Brown joins the attorneys general of Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, the District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, and Wyoming.

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