Employers, Unions, & Insurers

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PBMs administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurers, and labor unions, as well as through public programs such as Medicare and Medicaid. A common thread connecting all programs administered by PBMs is that success depends on offering the best overall value in terms of cost, quality, access, and convenience for health plan enrollees and saving clients money.

Negotiating price concessions on drugs is just one of the many ways PBMs reduce pharmacy benefits costs. PBMs encourage higher generic utilization, employ more affordable delivery options such as mail-service pharmacy, negotiate discounts from retail pharmacies, and help doctors and patients understand when safer, more affordable options are available.

PBMs understand that the “unit price” of a drug is only one of many different components of prescription drug spending. To ensure added value of these services to payers, PBMs provide employers, unions, and insurers with multiple formulary options, broad access to medications, convenient pharmacy options, and other benefits for enrollees.

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