FARE, the Food Allergy Research & Education organization, has expressed support for recent reforms to pharmacy benefit manager (PBM) practices included in a federal government funding bill signed into law on February 3, 2026. The new legislation mandates increased transparency and accountability among PBMs, which are entities that manage prescription drug benefits on behalf of health insurers.
The reforms were part of a broader package funding most federal operations, including the Department of Health and Human Services, for fiscal year 2026. FARE represents over 33 million Americans living with food allergies and has called this law an important first step toward improving patient access to essential medications.
Despite the legislative progress, FARE is urging Congress to require PBMs to add more epinephrine administration options beyond auto-injectors to their formularies. Recent innovations include a needle-free nasal spray form of epinephrine. This alternative may address some barriers patients and caregivers face when carrying or using epinephrine during emergencies. Epinephrine remains the only medication capable of reversing anaphylaxis—a severe allergic reaction—and any delay in its use can have life-threatening results.
However, according to FARE, many PBMs currently restrict access to these newer products by limiting coverage exclusively to auto-injectors even when other approved options exist.
Sung Poblete, PhD, RN, CEO of FARE stated: “We commend congressional leaders for moving this legislation forward but there is still more work to do. Our community needs PBMs to be required to include new epinephrine administration options on their formularies. There are few treatment options available for those managing food allergy, and it is unacceptable for PBMs to dictate which life-saving epinephrine administration option patients or caregivers may access. When seconds matter, having needle-free epinephrine available may be the difference between immediate treatment and a dangerous delay—and there is no way to justify that risk.”
FARE continues its advocacy efforts calling on Congress and federal regulators to address formulary practices that limit access to all available forms of epinephrine so families can choose the best option for their needs.
For further details about FARE’s initiatives and mission, information is available at www.foodallergy.org.
