States enacted significant pharmacy benefit manager reforms in 2025, with Arkansas implementing the nation's first PBM-pharmacy ownership ban despite facing legal challenges. Massachusetts passed comprehensive licensing requirements, while Colorado and California adopted "delinking" laws prohibiting PBM compensation tied to drug prices. Utah mandated rebate pass-through mechanisms. These diverse approaches reflect growing bipartisan momentum toward curbing PBM practices affecting independent pharmacies and drug pricing transparency.

Over the past month, arguably no Governor and Legislature have been as proactive in healthcare reform as newly elected Indiana Gov. Mike Braun (R) and Indiana’s General Assembly. In late January, the Governor issued six executive orders pertaining to healthcare access, affordability and transparency.