Pharmacy Benefit Managers (PBMs) play an important role in health care markets by setting up pharmaceutical networks and adjudicating pharmaceutical claims. Serving as middlemen for plans between pharmaceutical manufacturers and retailers, PBMs are well positioned to control pharmaceutical costs.
By creating networks of multiple pharmacies, PBMs leverage their size to negotiate contracts between drug manufacturers and retail outlets. They can secure rebates on certain drugs and are responsible for determining which drugs are covered by different health care plans.
However, over the years the PBM market has become a highly consolidated industry whose focus is not on serving consumers but on increasing company profits. Egregious and anti-competitive behavior on the part of the major PBMs has caused drug costs to skyrocket and harmed consumers and community pharmacists.
This website aims to outline the problems in the PBM market and provide resources to inform and empower consumers and pharmacists to combat many of the problems with PBMs. Visit our resources section to find informative documents, reports and testimonies about the PBM industry, and check out our links tab for other helpful websites on PBMs.
Here is a sheet with some common myths and facts about PBMs.