Relating to the relationship between a pharmacy benefit manager and a pharmacist or pharmacy.
Summary
HB 5457 would prohibit a pharmacy benefit manager (PBM) from directly or indirectly controlling, or being under common control with, a pharmacist or pharmacy in Texas. In practical terms, the bill is aimed at separating PBMs from pharmacies and pharmacists they may own, manage, or otherwise influence through affiliated business structures. The bill also directs the comptroller to produce a biennial report assessing how PBM regulation and affiliation affect independent and rural pharmacies, prescription drug prices, patient access to prescription drugs, and competition in the pharmacy market.
The bill includes a delayed implementation schedule. Although it would take effect September 1, 2025, existing PBM-pharmacy affiliations could continue temporarily until January 1, 2027, at which point affected entities would have to divest affiliated interests to comply. Beginning January 1, 2027, the Texas Board of Pharmacy would be required to revoke or refuse to renew pharmacy-related licenses for holders who remain affiliated with a PBM in violation of the new prohibition. The bill also repeals an existing Insurance Code provision effective the same date, signaling a broader restructuring of state law governing PBM-pharmacy relationships.
Impact
HB 5457 would amend the Texas Insurance Code to create a new prohibition on PBM ownership or control of pharmacies and pharmacists, and it would amend the Occupations Code to tie licensure consequences to noncompliance. The bill would also require recurring state-level reporting on the market and consumer effects of PBM affiliation, giving lawmakers a formal mechanism to evaluate impacts on independent and rural pharmacies, drug pricing, access, and competition. Existing affiliated arrangements would be grandfathered only temporarily, with a mandatory divestiture deadline of January 1, 2027.
Sentiment
No committee transcript or vote record is provided, so there is no direct evidence of debate or recorded support/opposition in the materials supplied. Based on the bill text alone, the measure appears to reflect concern about PBM market power and its effects on pharmacy competition, especially for independent and rural pharmacies. The inclusion of a legislative report requirement suggests an interest in building a policy record and monitoring consequences over time.
Contention
The main likely point of contention is whether Texas should prohibit PBMs from owning or controlling pharmacies at all, versus allowing affiliated structures while regulating conduct. Supporters would likely argue the bill protects competition, independent pharmacies, and patient access, while critics may contend it is overly restrictive, could disrupt existing business models, and might not actually lower prescription drug costs. The delayed effective date and grandfathering period indicate an attempt to soften the transition for existing affiliations, which may have been intended to address industry concerns about immediate disruption.
Provides for fair pharmacy reimbursement from a pharmacy benefit manager, and also provides anti-discrimination prohibitions in regard to non-affiliated pharmacies or pharmacists.
Provides for fair pharmacy reimbursement from a pharmacy benefit manager, and also provides anti-discrimination prohibitions in regard to non-affiliated pharmacies or pharmacists.