Trump’s 2025 Drug Pricing & PBM Reforms: What They Mean for You

Prescription drug pricing has been a broken puzzle for decades. Most people just see the final number on the pharmacy receipt, but behind that number are layers of backroom deals, rebate systems, and unchecked middlemen called pharmacy benefit managers, or PBMs.

Now, a new executive order from former President Trump is shining a national spotlight on PBMs, calling for the most aggressive federal reforms in years.

So, what does it actually say?

Trump’s 2025 Executive Order directs federal agencies to:

• Increase PBM competition

• Improve rebate transparency

• Promote the use of generic and biosimilar drugs

  
  

These are not vague ideas. They’re specific mandates with real implications for patients, pharmacies, and the entire healthcare system.

Why PBMs are finally under scrutiny.

PBMs control what medications are covered, which pharmacies are in-network, and how much patients pay out of pocket. They sit between insurers, drug manufacturers, and pharmacies, and they’ve become some of the most profitable players in healthcare.

Yet most people have never heard of them.

That’s why this order matters. It’s not just a policy shift. It’s a cultural one. A call to break open the black box of drug pricing and give patients clarity.

One major reform gaining traction: PBM reverse auctions.

Here’s how it works:

Instead of PBMs dictating prices behind closed doors, states or federal programs hold auctions. PBMs submit bids for the right to manage a plan’s drug benefits. The lowest, most transparent bidder wins.

It flips the model. It makes PBMs compete on price and value,not on how many backdoor rebates they can negotiate.

Six U.S. states have already implemented this model. Early data shows savings, accountability, and a better deal for public health plans and the people they serve.

The PBM Accountability Project is going even further.

This growing coalition is pushing for:

• Full visibility into manufacturer rebates

• Redirecting savings to patients and public programs

• Ending spread pricing (where PBMs pocket the difference between what they charge insurers and what they pay pharmacies)

• Implementing more reverse auction systems nationwide

  
  

What it means for your wallet.

If these reforms go through, patients could see lower drug prices, fewer surprise denials, and a healthcare system that feels a little less like a maze.

For independent pharmacies, it could mean fairer contracts, faster payments, and fewer roadblocks just to serve their communities.

And for everyone? It means more transparency. More competition. More accountability.

We’ve seen what happens when the system is allowed to operate in the shadows.

Patients pay more. Pharmacies close. Middlemen profit.

That’s why we support any reform, Republican or Democrat, that puts patients first.

At Birmingham Apothecary, we’ve served our community since 1914. We believe in transparency, fair pricing, and putting people before profit. This new wave of reform could finally bring those values into the mainstream.

It’s long overdue.

Because medication access shouldn’t depend on secret deals. It should depend on what’s best for your health.