NJ S3842

Establishes a fiduciary duty for pharmacy benefits managers (PBMs) to prioritize the long-term health outcomes of covered persons and prohibits PBMs from using misleading marketing to steer patients toward contracted pharmacies

Requires PBM compensation to be structured as flat fees only, prohibiting commission-based arrangements

Invalidates any PBM-manufacturer agreement that conditions rebates on excluding generic drugs from coverage

Mandates PBMs reimburse contracted and network pharmacies at least at the pharmacy's drug acquisition cost, while independent pharmacies must be reimbursed at no more than 5% below contracted pharmacy rates but never below acquisition cost

Requires pharmacy and therapeutics committees to ensure higher-cost brand-name drugs are not placed in more favorable formulary positions than lower-cost generic or biosimilar alternatives