PBMs to Remain a Prominent Area of Focus Pharmacy benefit manager (PBM) reform has been an active and evolving area for policymakers in Washington, D.C. for many years but reform efforts have noticeably picked up pace in 2026. Recent actions by Congress and the Trump administration underscore how PBM reform has gained new momentum this year and continues to be a key area of focus for policymakers as they consider health care affordability, transparency, and drug pricing issues. These actions present new oversight, enforcement and compliance considerations.