What's Next For Pharmacy Benefit Managers?

2025-02-14 03:20:00 ET

Summary

• In the U.S., Pharmacy Benefit Managers serve as middlemen between insurers, drug manufacturers, and pharmacies, primarily by negotiating rebates on medications and promoting the use of generic drugs.
• On the revenue side, PBMs get paid by insurance companies to secure rebates from drugmakers in exchange for favorable placement in the insurers’ health plans.
• In our view, the traditional PBM model will continue to be under threat — including from President Trump — and increasingly vulnerable to disruption.

By Trevor Perry

These giant middlemen claim they help keep drug costs in check, but scrutiny-and competition-are brewing. ...

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