Forbes December 16, 2024
Pharmacy benefit managers received substantial attention during 2024. Congress and regulating agencies including the FTC and HHS scrutinized PBM business practices and related profits. As a new Congress prepares to be seated, this topic remains an important part of the healthcare equation to solve.
PBMs began operating in the 1960s to help insurers increase the value of the pharmacy benefit and manage drug spending by encouraging the adoption of generic drugs when medically appropriate and by administering drug claims. PBMs evolved in the 1990s to create tiered formularies and negotiate rebates with drug manufacturers, leveraging their market influence to lower net drug prices. During the past 15 years, PBMs have expanded their services to include drug utilization reviews, disease management...
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