How legislative, regulatory and litigation forces are reshaping pharmacy strategy

Author: Nathan Drapkin

The US drug‑pricing environment is shifting rapidly — and this time, the changes aren't temporary. States, federal agencies and the courts are all driving reforms that affect pharmacy costs, benefit design and contract strategy. Employers will face more variability, more oversight and more pressure to make informed decisions quickly.

For employers, this shift means:

  • More cost volatility
  • More state‑specific rules
  • More scrutiny on pharmacy benefit managers (PBMs)
  • Less predictability
  • Greater urgency to adapt quickly

This whitepaper summarizes the major forces shaping 2026 and provides practical, employer-focused guidance on how to navigate this environment. Talk to a Gallagher Pharmacy and Health Plan Services consultant or visit ajg.com/pharmacy to learn more.

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Consulting and insurance brokerage services to be provided by Gallagher Benefit Services, Inc. and/or its affiliate Gallagher Benefit Services (Canada) Group Inc. Gallagher Benefit Services, Inc. is a licensed insurance agency that does business in California as "Gallagher Benefit Services of California Insurance Services" and in Massachusetts as "Gallagher Benefit Insurance Services." Neither Arthur J. Gallagher & Co., nor its affiliates provide accounting, legal or tax advice.