MedPage Today August 7, 2024
— Competitors say their per-member, per-month payment model is fairer to employers and insurers
As the Federal Trade Commission (FTC) and Congress turn their attention to the business practices of pharmacy benefit managers (PBMs), companies are springing up to provide alternative ways for employers to manage their drug benefits.
Under the traditional model that has been used by the “Big Three” PBMs — CVS/Caremark, ExpressScripts, and OptumRx, which together comprise about 80% of the market — the PBM made its money in several ways, including through rebates — discounts — from drug manufacturers, and “spread pricing,” in which the PBM charges employers and insurers more for the drug than it pays to the pharmacy. PBMs have also used other tactics,...
Today's Sponsors
Today's Sponsor