What is a Pharmacy Benefit Manager (PBM)?


The ongoing debate over rising prescription drug prices may have exposed many consumers to a term of which they may never have heard before: Pharmacy Benefit Managers (PBMs).

What, exactly, is a PBM?

In short, PBMs administer prescription drug plans for consumers who have health insurance from commercial health plans, self-insured employer plans, Medicare Part D plans, union plans, the Federal Employees Health Benefits Program, and state government employee plans.

According to the trade association for PBMs, the Pharmaceutical Care Management Association (PCMA), PBMs administration prescription drug plans for more than 266 million Americans.

According to PCMA, PBMs “are projected to save employers, unions, government programs, and consumers $654 billion - up to 30 percent - on drug benefit costs over the next decade, according to research from Visante.”

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