High Priced Drugs

America’s PBMs are the only member of the prescription drug supply
and payment chain working to reduce high drug costs, improve patient
access, and increase affordability.

PBMs administer prescription drug plans for more than 266 million Americans with health coverage through employers, health insurers, labor unions, Medicare and Medicaid. Using innovative cost-saving tools and technologies, PBMs are working every day on behalf of patients and payers to increase affordability and access to prescription drugs.



Prescription drug spending is projected to grow at 5.4% per year between 2021–2023.


Drug manufacturers increased list prices by an average 6.8% on 857 drugs between January and June 2020.

PBMs have reduced costs and have a return on investment for payers of $10 for every $1 spent on PBM services.

High-Priced Drugs Hurt Patients’ Wallets and Health

High-priced prescription drugs contribute to financial and medication access barriers for patients, with cost being the most cited reason for non-adherence. Poor prescription drug adherence has been shown to result in worse health outcomes and increased health care costs.


PBMs: Committed to Helping Patients

Unlocking an Affordable Future

Building Toward a More Accessible and Affordable Health Care Future

As pharmacy benefit experts, our companies secure lower prescription drug costs, enable better health outcomes for patients, and offer employers and other health insurance plan sponsors the choices and guidance they need to expand access and provide quality prescription drug coverage for 275 million people in the United States.

Promotion of Higher-Cost Drugs

Manufacturers promote the use of higher cost drugs using coupons, copay cards, direct-to-consumer advertising, and physician payments.

  • The number of branded drugs that offered coupons rose from 278 in 2012 to 701 in 2018 and the total dollar value of redeemed coupons reached $13 billion nationwide that year. 
  • The prices for brand drugs with coupons are rising 12-13% every year, compared to 7-8% increases for brand drugs without coupons. 
  • Banning copay coupons would lower prescription drug costs by approximately $1.2 billion per year.”


Why PBMs?

PBMs increase access and lower Rx costs for 275 million patients with health coverage provided by commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.75

Case Study: How PBMs Save on Insulin

Managing Costs with Increasing Manufacturer Prices