Pharmacy benefit managers (PBMs) have been acting as a middleman in the prescription drug supply chain since the late 1960s. For decades, their role has been seen as essential to insurance plans, but behind the scenes, they have the ability to influence which drugs are covered, how much they cost and who can get them.
This lack of transparency in the industry can put patients at risk, according to the American Medical Association. “As PBMs increasingly act in their own self-interest without transparency or accountability, drug prices rise and patients face health risks from cost-prohibitive drug treatments,” noted AMA President Bobby Mukkamala, M.D. By adding unnecessary complexity and cost, PBMs often stand between patients and the medications they need.
