A policy panel discussion highlighted how U.S. PBM reform rules are forcing operational change through mandatory rebate pass-through and transparency requirements. Brendan Buck of the Pharmaceutical Care Management Association (PCMA) said the new law is among the most significant reforms in years, but warned that pressing the “PBM lever” alone will not fix affordability. The remarks focused on implementation friction for employers, including risk-spreading decisions for high-cost specialty drugs once rebates flow directly to sponsors rather than being retained or managed by PBMs. Buck also flagged potential compliance conflicts tied to overlapping transparency obligations. The discussion frames PBM reform as an ongoing political issue, with the near-term impact likely to show up in benefit design and pharmacy coverage strategy rather than just drug pricing.