Get the Facts
How PBMs reduce the cost of high-priced drugs

Fact: PBMs are leveraging competition and driving deep discounts on high-priced drugs for consumers, employers, unions, and government programs. A recent study showed that PBMs negotiated better discounts on expensive hepatitis C medications than most European, price-controlled countries.

How does drug
pricing work?

How do prescription drug rebates
reduce costs?

What is drug

price transparency?

What is a
Pharmacy Benefit Manager (PBM)?

Who hires a
Pharmacy Benefit Manager (PBM)?

How do specialty pharmacies lower costs and improve quality?

  • Costs for hepatitis C drugs were nearly cut in half when new brand competitors entered the marketplace. When there is real competition in the market, PBMs can negotiate rebates and discounts that lower prescription drug costs for consumers.

     

  • The FDA could facilitate greater competition by approving generics, brands and biosimilar competitors faster so they could get to market more quickly.

The Return on Investment (ROI) on PBM Services

Pharmacy benefit managers (PBMs) help payers and patients save 40-50% on their annual drug and related medical costs.

PBMs Generating Savings for Plan Sponsors and Consumers

Pharmacy benefit managers (PBMs) now implement prescription drug benefits for some 266 million Americans who have health insurance, and will save $654 billion over 10 years.

Negotiated Hepatitis C Prescription Drug Costs in the United States Often Cost Less Than in Price-Controlled European Countries and Japan 

At $50,400, the net U.S. price per course of treatment for Harvoni was below the net price in France, Japan, Spain, Germany, and the U.K. in 2015.

StatNews: These pricey cholesterol drugs aren’t selling, and that has the biotech industry sweating

A year ago, two new drugs that used a novel mechanism to drive down cholesterol levels came on the market, and were promptly crowned as blockbusters in-waiting. Analysts estimated sales at more than $3 billion a year.

Pharmacy Benefit Managers: Part of the solution to high drug prices 

As policymakers consider new ways to reduce prescription drug costs, they should start by rejecting schemes to undercut the cost-savings tools widely used by employers, unions, health plans, and popular, affordable programs like Medicare Part D. Specifically, lawmakers must protect the ability of the employers and unions that provide coverage – and the pharmacy benefits managers (PBMs) they hire – to negotiate aggressive discounts from competing drug companies. 

PBMs: Protecting Consumers and Employers From High Drug Prices

The competition-based PBM approach has been highly successful, yielding broad access to prescription drugs and 90% consumer satisfaction rates. A recent study shows PBMs are on track to reduce prescription drug coverage costs by $654 billion over the next decade for government and commercial payers.

American Action Forum: The Donald has Spoken 

The reality is that the president cannot use government negotiations to lower drug prices. Despite the repeated assertions to the contrary, there are tons of negotiations in the Medicare drug program. They are private negotiations between and among prescription drug plans, pharmacy benefit managers, and drug manufacturers — and they produce substantial price reductions. The government doesn’t add anything to this mix because it doesn’t have a formulary that would allow it to favor one drug over another, and negotiate a discount in exchange. The reality is that the federal government has no such mechanism to discriminate, and thus no real ability to more effectively negotiate.