November 21, 2016
An analysis from Visante quantifying how PBMs generate $6 in savings for each $1 spent on their services. Major Findings...
One of the most important functions performed by PBMs is obtaining discounts on drugs for health plans and patients through the negotiation and administration of manufacturer purchase and rebate agreements. PBMs are able to lower drug spending by negotiating price discounts from pharmacies, by negotiating discounts from wholesalers, and by negotiating directly with drug manufacturers for purchase discounts.
Competition among drug products depends on the number of alternative therapies available within each therapeutic class. In classes where several products may be considered therapeutically equivalent, PBMs can negotiate with drug manufacturers for higher rebates, which in turn benefit patients and payers.
October 13, 2016
Executive Summary This study examines whether the full range of pharmacy benefit management (PBM) tools are being allowed and used...
April 19, 2017
(Washington, D.C.) — A new market analysis contradicts claims that drug pricing is contingent on the level of rebates and discounts manufacturers negotiate with the pharmacy benefit managers (PBMs) that represent employer, union, and government plans offering prescription drug coverage....
February 08, 2017
(Washington, D.C.) — As part of its DrugBenefitSolutions.com campaign, the Pharmaceutical Care Management Association (PCMA) today released a new video,...
January 30, 2017
(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) issued the following statement on today’s new class-action lawsuit against three...
August 05, 2016
CVS Health — At CVS Health, we are acting vigilantly to help our clients contain their costs while supporting their...
Specialty Drug Trends
Complex, innovative, and high-priced specialty drugs are entering the United States health care market at a rapid rate.
What is a specialty pharmacy network?
To maximize the patient benefit of drug treatments, preferred specialty pharmacy networks are used to deliver high-quality, accessible pharmacy services.
What is a PBM?
These drugs are best defined by the full range of each product's attributes, rather than solely by cost and route of administration.
What tools do PBMs use?
The total costs and utilization of specialty drugs will have a substantial impact on overall health care costs during the next decade.