Pharmacy Benefit Managers (PBMs)

Pharmacy Benefit Managers (PBMs) are intermediaries between health insurers, pharmacies, and drug manufacturers. Their role is to manage prescription drug benefits for health plans, helping to negotiate prices, create formularies (lists of covered medications), and implement cost-control measures. By doing so, they aim to lower medication costs for health plans and consumers while ensuring access to necessary medications. However, their practices can sometimes lead to debates about transparency in pricing and the impact on overall healthcare costs. Essentially, PBMs play a significant role in shaping how prescription medications are accessed and priced in the healthcare system.