This action brief examines the key barriers employers face when contracting with pharmacy benefit managers (PBMs), and how recent legislation may present a step in the right direction towards greater transparency. However, significant work remains to ensure employers can secure the best possible pricing and effectively support the healthcare needs of their employees and families. In today’s increasingly complex pharmacy benefits landscape, employers that understand how PBMs generate revenue, structure contracts, manage formularies, and align incentives are better positioned to make informed decisions and achieve stronger outcomes. By applying the principles outlined in this action brief, employers can strengthen oversight of their pharmacy benefit program and negotiate more effective and accountable contracts.