Pharmacy Benefit Managers (PBMs) play a large role in deciding which drugs patients receive and how much they pay. Yet their fees, rebates, and contracts remain largely hidden from employers, insurers, hospitals, and pharmacies. Opaque practices have led to PBMs favoring high-cost medicines instead of less expensive options. The solution is transparency: when the rest of the market can see how PBMs operate, competition can encourage real savings.
In today’s market, PBMs profit when list costs and rebates are large. In a practice called spread pricing, PBMs make a profit by charging...