
The National Association of Chain Drug Stores (NACDS) is celebrating a decisive victory for Illinois patients, pharmacies, and communities as Governor J.B. Pritzker signs House Bill 1697, the Prescription Drug Affordability Act, into law. This landmark legislation delivers robust reforms to pharmacy benefit manager (PBM) oversight, prescription drug pricing, pharmacy access, and health insurance requirements across the state.
With overwhelming bipartisan support — 56-1 in the Senate and 115-1-1 in the House — Illinois lawmakers have responded to urgent calls from constituents to address further the opaque PBM practices that have driven up drug costs and limited patient access. The bill bans spread pricing, mandates that PBMs pass through 100% of manufacturer rebates to health plan sponsors or patients, and protects pharmacies participating in the 340B drug discount program from unfair discrimination.
“This legislation reflects Illinois’ dedication to supporting patients, employers, and the local pharmacies which they rely on for their healthcare,” said NACDS President and CEO Steven C. Anderson. “Governor J.B. Pritzker and the Illinois legislature have demonstrated remarkable leadership by enacting this comprehensive legislation. By pushing for greater transparency and responsibility from PBM middlemen, Illinois is taking a stand for more affordable prescription drugs and increased patient choice, while recognizing the essential role that pharmacies have in our neighborhoods.”
The new law sets a high bar for transparency, requiring PBMs to submit detailed annual reports to the Department of Insurance, plan sponsors, and insurers. These reports will capture data on drug utilization, rebates, spending, and contracts — delivered in plain language and summary form for consumers. The law also introduces a tiered PBM registration and fee structure, with proceeds fueling the Prescription Drug Affordability Fund to further support patients.
Illinois’ action is part of a broader national surge in PBM reform. In 2024 alone, 24 states enacted 33 PBM reform bills, resulting in 74 policy changes in line with NACDS priorities. From 2021 to 2023, 131 new PBM laws took effect nationwide, demonstrating a groundswell of bipartisan momentum. Recent Federal Trade Commission reports have spotlighted PBMs for marking up specialty generic drugs by thousands of percent, generating more than $7.3 billion in excess revenue from 2017 to 2022.
“For too long, PBMs have operated in the shadows, driving up costs and limiting access to essential medications — the fight against their abuses demands resolve at every level of government,” Anderson said. “This bill builds upon the numerous PBM reforms that Illinois has passed since 2016. Representative Natalie Manley and Senator Dave Koehler deserve tremendous credit for keeping the momentum going, championing this bill, and ensuring its passage. We are deeply grateful to our state partners, the Illinois Pharmacy Association and Illinois Retail Merchants Association, for their unrelenting advocacy over the years.”
Most provisions of the Prescription Drug Affordability Act take effect Jan. 1, 2026, although key provisions related to PBM registration and reporting are effective immediately. The law also creates a Critical Access Care Pharmacy Program, supporting the sustainability pharmacies in rural, high-poverty, and underserved communities, ensuring they can continue to provide vital services to the patients they serve.