This bill, titled the Delinking Revenue from Unfair Gouging Act (DRUG Act), aims to significantly reform how pharmacy benefit managers (PBMs) are compensated for their services related to prescription drug benefits. Beginning January 1, 2027, PBMs will generally be prohibited from deriving any remuneration from entities for services, benefit administration, or other activities concerning prescription drug benefits under group health plans or health insurance coverage. The legislation introduces a crucial exception for "bona fide service fees." For a fee to qualify, it must be a flat dollar amount, explicitly set forth in an agreement, and cannot be directly or indirectly based on drug prices, benchmark prices, or the amount of discounts, rebates, or other remuneration related to prescription drugs. This aims to delink PBM compensation from drug costs. A "bona fide service fee" is defined as a fee equal to the fair market value of an itemized service actually performed, which the entity would otherwise perform or contract for, and is not passed on to a client or customer. The bill broadly defines a "pharmacy benefit manager" to include any entity that acts as a price negotiator or manages/administers prescription drug benefits, regardless of its self-identification. Enforcement of these provisions will be carried out by the Secretaries of Health and Human Services, Labor, and the Treasury. PBMs found in violation will be required to disgorge any improperly received payments to the affected group health plan or health insurance issuer. Additionally, violators will face a civil monetary penalty of $10,000 for each day the violation continues. The bill clarifies that it does not prohibit payments for ingredient costs or pharmacy dispensing fees, nor does it prevent rebates, discounts, or other price concessions from being fully passed through to lower net prescription drug costs. The Secretaries are mandated to implement this section through interim final regulations, and the bill amends the Public Health Service Act, ERISA, and the Internal Revenue Code to enact these changes.