Lexology October 17, 2023
Introduction
The price of prescription drugs has brought scrutiny to the entire drug supply chain. Congress and other policymakers continue to seek opportunities to lower costs for patients and the federal government.
Pharmacy benefit managers (PBMs) are a key stakeholder in the drug supply chain, functioning as intermediaries between insurance providers and pharmaceutical manufacturers. PBMs administer prescription drug benefits and seek discounts for insurers as standalone plans, such as Medicare Part D plans, or as entities embedded in commercial insurance products, including Medicare Advantage (MA), Medicaid Managed Care Organizations and employer-sponsored coverage. PBMs often create formularies, negotiate rebates with drug manufacturers, process claims, create pharmacy networks, review drug utilization, and manage mail-order specialty pharmacies. PBMs most often play...
Today's Sponsors
Today's Sponsor