Let’s Shed Some Light on the Pharma Middlemen
Pharmacy benefit managers are at the center of an opaque supply chain that delivers outrageously expensive drugs.
Transparency is good.
Photographer: Spencer Platt/Getty Images
The US spends more on prescription drugs than any other country in the world. It’s easy to blame drugmakers, but they’re by no means the only ones at fault. Lowering costs will also require lawmakers to scrutinize pharmacy benefit managers, the middlemen in a bewilderingly opaque supply chain.
PBMs started in the 1960s as a “back office” for health plans to process claims. Over time, they expanded their reach — negotiating rebates from drugmakers; creating lists of drugs, known as formularies, that providers of health benefits agree to cover; and developing networks of preferred pharmacies.