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 PBM-Plan Sponsor Relationships In A Post-Rebate World

PBM-Plan Sponsor Relationships In A Post-Rebate World

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In today’s complex and costly health care system, payers are seeking greater transparency, accountability and affordability. Many don’t believe they are getting it from their pharmacy benefit manager (PBM). In fact, 63 percent of employers stated in a recent survey that PBMs aren’t transparent, especially when it comes to revenue streams.1 However, payers aren’t alone, patients are looking for greater transparency and affordability, too, especially in light of the fact that one in four people can’t afford their medications.2 They want to understand what they are paying ahead and of time and know they can afford their much needed medications. With an outcry from payers and patients, government legislatures from across the nation have gotten involved. States have proposed bills in an attempt to demand transparency and better control cost at the PBM level.

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1. Toward Better Value: Employer perspectives on what’s wrong with the management of prescription drug benefits and how to fix it, National Pharmaceutical Council, 2017, page 8.
2. Kaiser Family Foundation Health Tracking Poll, 2016.