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Companies ditching massive drug-industry middlemen in favor of smaller competitors

  • Jun 28, 2021
  • PBM Model
Pharmacy benefit managers are facing a wave of fresh scrutiny from states over the secretive ways they turn profits.

That's helping to fuel business at smaller firms and venture-backed startups that say they operate differently.

PBMs are middlemen that handle prescription-drug benefits for health plans and companies that provide health benefits for their employees. About 157 million people get health coverage through their jobs.

PBMs say they save companies money by negotiating discounts from drugmakers, but official audits in Ohio, Delaware, Florida, and other states have exposed how some PBMs mark up drug prices and pocket the difference.

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Associated People