Guest Blog by E. Michael Murphy, PharmD, MBA, Senior Advisor for State Government Affairs, American Pharmacists Association, Assistant Professor of Clinical Pharmacy, The Ohio State University College of Pharmacy
The first half of 2025 has demonstrated just how powerful pharmacy advocacy can be when national and state organizations work in alignment. Across the country, legislation is being introduced, debated, and enacted that strengthens the role of pharmacists in patient care, increases transparency in prescription drug pricing, and protects access to local pharmacy services.
This work is driven by the strategic and persistent efforts of state pharmacy associations who are advancing bold, patient-centered agendas in their state legislatures. APhA is proud to support and partner with these organizations to provide policy expertise, amplify local efforts, and help ensure lawmakers understand the vital role pharmacists play in our health care system.
Legislative trends
The 2025 state legislative sessions have so far been defined by three major trends: expanding pharmacists’ authority to provide care, securing payment for pharmacist-provided services, and reforming the business practices of PBMs.
Across more than 40 states, legislators have introduced bills designed to modernize pharmacy practice and address health care gaps. While each state’s approach is unique, the underlying message is the same: pharmacists are essential, accessible health care providers, and the law should reflect that reality.
2025: The year of PBM reform
Perhaps no issue has unified the pharmacy profession this year like PBM reform. From coast to coast, states are passing legislation that increases transparency, protects patient access, and ensures pharmacies are paid fairly for the medications and services they provide. Many of these new laws include reimbursement floors, anti-steering protections, audit reform, and requirements for pass-through pricing.
Here are just a few highlights:
- Indiana passed a comprehensive PBM reform bill, including establishing fair network requirements, PBM reporting requirements, setting a reimbursement floor to ensure pharmacies are reimbursed fairly for dispensing medications, and other vital provisions to support sustainable pharmacy business models.
- Colorado required PBMs to adopt transparent fee structures, banned reimbursement practices tied to drug prices, and mandated reimbursement to pharmacies at or above the National Average Drug Acquisition Cost (NADAC) with a reasonable dispensing fee. It also requires PBMs to share prescription cost data with health plans and prohibits conflicts of interest in formulary design.
- Iowa implemented sweeping PBM reforms, including nondiscrimination requirements, mandatory pass-through pricing, full rebate pass-throughs to health plans, and reimbursement to pharmacies based on NADAC and a professional dispensing fee of $10.68. It banned PBM practices that steer patients to mail-order pharmacies and restrict pharmacy participation, while strengthening network and pricing transparency.
- Nevada and Virginia enacted legislation to transition their Medicaid programs to a single, state-contracted PBM model, aiming to increase transparency, reduce administrative complexity, and ensure more consistent and equitable pharmacy reimbursement.
- Arkansas, North Dakota, and Montana also enacted laws to curb predatory PBM behaviors and protect pharmacies from discriminatory practices.
Notable legislative wins in scope of practice and coverage for services
While PBM reform has taken center stage, states are also making progress in other critical areas:
- Pharmacist payment and recognition: States such as Hawai’i and Utah enacted laws that require both public and private health plans to reimburse pharmacists for services within their scope of practice. Oregon adopted provisions that require Medicaid reimbursement for pharmacists providing HIV PrEP and PEP services.
- Patient care services: Several states acted to expand the services pharmacists can provide. West Virginia and Oregon solidified pharmacists’ ability to test and treat for certain conditions. Virginia expanded collaborative practice authority to allow pharmacists to manage drug therapies, including controlled substances.
APhA’s role in state advocacy
As state legislative sessions unfold, APhA continues to work closely with state pharmacy associations, lawmakers, and regulatory agencies to advance meaningful policy change. Our support takes many forms: from reviewing bill language and developing testimony to submitting official comments, organizing grassroots campaigns, and meeting directly with state leaders.
This is a collaborative effort. State pharmacy associations lead the charge, and APhA provides the tools, national coordination, and technical assistance to help those efforts succeed.
Why this matters—and how you can help
The momentum we are seeing is a direct result of sustained, strategic advocacy. But policy change does not happen on its own. It takes membership. It takes voices. It takes pharmacists, student pharmacists, and pharmacy technicians across the country showing up, speaking out, and supporting the work of their professional associations.
If you are not already a member of your state pharmacy association and APhA, I encourage you to join today. Your support helps ensure that the work happening in state capitals and across the country continues to gain ground.
Together, we are changing the laws that shape our profession, so our patients have access to the care they deserve. I know we’ll go even farther with your help.
Want to get more involved in advocacy or share a bill APhA should be watching? Email us at APhAGovernmentAffairsTeam@aphanet.org and reach out to your state pharmacy association.