Drug pricing reform has received renewed attention in recent months, but one entity always seems to escape unscathed in reform efforts: pharmacy benefit managers (PBMs). Even the most recent federal drug pricing legislation, the Inflation Reduction Act, ignores the role that PBMs play in drug pricing. It went as far as to delay a rule that would have had an immediate reduction in Medicare beneficiary cost sharing. In their original form, PBMs adjudicated pharmacy claims but over the years, these entities evolved into money-making behemoths at the expense of patients and employers.
top of page
bottom of page