The Department of Labor’s proposal would force pharmacy benefit managers to disclose drug pricing details to employers and open their books to audits. More than 500 comment letters show PBMs and insurers fighting the rule, while some employers and startups back it and drugmakers offer mixed support.

Mark Cuban and Optum CEO Patrick Conway engaged in a heated discussion about drug prices and pharmacy benefit managers, highlighting their differing views on how to reform the healthcare system. Cuban argued for breaking up large insurance companies and criticized the lack of transparency in PBM contracts, while Conway emphasized the need to tackle high hospital and pharmaceutical costs. Both acknowledged the other's contributions but remained divided on the root causes of high drug prices and solutions.