News|Articles|December 25, 2025

Top 5 stories from Formulary Watch in 2025

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Key Takeaways

California's law enhances pharmacy supply chain transparency by banning spread pricing and mandating rebate pass-throughs to health plans.
Pharmacogenomics, used by PBMs, optimizes medication prescribing by considering genetic factors, reducing trial-and-error, and saving costs.
Reforming PBM compensation models, as suggested by experts, could potentially save nearly $100 billion in U.S. drug spending.
The PBM industry is urged to adopt transparent models that avoid conflicts of interest and misaligned incentives.
Over 50 insurers have committed to reforming the prior authorization process, aiming for streamlined and simplified procedures.

Transparency, prior authorization, PBM reform and PBM offered genomics testing are some the trends Formulary Watched tracked in 2025.

California PBM law is a starting point for real transparency

A California law prohibits spread pricing and requires all rebates to be passed to health plans and is an important step toward transparency across the entire pharmacy supply chain.

PBM-offered genomics testing could reshape prescribing of medications

Two PBMs, True Rx Health Strategies and Capital Rx, are using pharmacogenomics — how a person’s DNA affects their response to medications — to reduce the trial-and-error of prescribing medications, saving employers and patients time and money.

PBM reform could save almost $100 billion in U.S. drug spending

Health policy researcher Geoffrey Joyce argues that only delinking compensation from the list price of a drug will lower drug spending.

Transparency for PBMs. Can it become something more than just a buzzword?

The pharmacy benefit manager (PBM) industry is under pressure to shift to models that avoid conflicts of interest and misaligned incentives.

Plans agree to prior auth Reform. Physicians and business groups want measurable results

More than 50 insurers have pledged to streamline and simplify the prior authorization process through six new commitments.

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Top 5 stories from Formulary Watch in 2025

Key Takeaways

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