Policy Tailwinds for Pharmacies Amid Ongoing Reimbursement Challenges
Retail pharmacy chains have long since navigated an uncertain reimbursement landscape that has driven a slew of pharmacy closures in 2025. Now, the policy environment is finally starting to tilt in their favor.
In this special research report, Washington Analysis—a CFRA business—shares insights from a recent expert-led conference call with a leading regulatory expert discussing the impact of PBM reform, shifting drug pricing benchmarks, and the evolving implementation of the Inflation Reduction Act (IRA).
Key takeaways suggest a moderate but meaningful tailwind for CVS, Walgreens Boots Alliance (WBA), and RiteAid. Moves toward National Average Drug Acquisition Cost (NADAC)-based reimbursement, more predictable fee adjudication and mandatory centralized procurement facilitators all represent potential positives recently finalized through legislative and regulatory means. Meanwhile, state-level prescription drug affordability boards (PDABs) and pharmacy benefit manager (PBM) contracting still present reimbursement and liquidity risks.
Chain drugstores, facing years of margin compression and store closures, may benefit from increased regulatory clarity—particularly as PBMs are stunted through legislative reform in their ability steer volume and shrink margins. But the real question remains: Will reforms gain traction in a crowded policy year?
What You Will Learn
- Why proposed PBM reform could stabilize reimbursement and reduce pharmacy closures
- How NADAC pricing and IRA “smoothing” provisions are reshaping pharmacy cash flow expectations
- Why large pharmacy chains may benefit while independent pharmacies remain at risk
- The impact of new CMS rules including automatic enrollment in the Medicare Prescription Payment Plan at the point of sale
- How state-level PDAB proposals could pose reimbursement risks in key markets
This report breaks down how national and state-level policy shifts could shape the future of the pharmacy sector and which players are best positioned to weather or win from these developments.
Report Authors Include:
- Monet Stanford, PharmD, Senior Vice Present, Healthcare Policy
- Laura Hobbs, Senior Vice Present, Healthcare Policy
- Tatiana Johnson, Senior Vice Present, Healthcare Policy
- Ryan Visnovec, Senior Research Associate
