FOR IMMEDIATE RELEASE
Wednesday, April 29, 2026
Contact: comms@ncdoj.gov
919-538-2809
RALEIGH – Attorney General Jeff Jackson and a bipartisan group of attorneys general are pushing the U.S. Department of Labor to help lower prescription drug costs by requiring more transparency from pharmacy benefit managers (PBMs).
“People should be able to afford their medications, and they can’t if PBMs are hiking up the costs,” said Attorney General Jeff Jackson. “We need to know how these companies are conducting business so we can protect patients.”
PBMs are third-party administrators of prescription drug benefits. They act as a middleman between insurance companies and drugmakers for almost every American who receives health insurance. Because of this, these companies have a lot of control over which prescription drugs are covered and how much they cost, with the three largest PBMs managing roughly 80 percent of prescription claims in the United States. However, PBMs are often not transparent on how they make money or why drug costs change.
Attorney General Jackson and 44 other attorneys general recommend that the Labor Department require PBMs to disclose how they make money twice a year and to let employers who fund health insurance plans audit them.
All 50 states have laws that regulate PBMs. In North Carolina, the legislature passed the SCRIPT Act in 2025. It requires PBMs to allow any pharmacy to participate in their networks, allow patients to use their preferred pharmacy, pass most savings negotiated with drugmakers to patients, submit reports on benefits and reimbursements, and more fairly reimburse independent pharmacies.
PBMs have previously tried to avoid state regulations by claiming that the Employee Retirement Income Security Act of 1974, a federal law that set standards for retirement and health plans, takes precedence over state laws. The attorneys general urge the Labor Department to clarify that a federal rule on transparency would not exempt PBMs from state transparency laws.
Attorney General Jackson has previously fought to ensure fair drug prices for North Carolinians. In February, he and Insurance Commissioner Mike Causey sent a letter alerting PBMs that they would uphold the SCRIPT Act and “pursue all available remedies under law” when warranted.
Attorney General Jackson is joined in submitting the letter to the Labor Department by 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, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wyoming.
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