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How PBMs Reduce Drug Costs in High-Deductible Plans

Fact: As medical costs rise, more employers, unions, and government programs are offering lower cost, high-deductible plans. Pharmacy benefit managers (PBMs) help stretch health care dollars further by reducing pharmacy costs by 30%.

Pharmacy Benefit Managers

  • PBMs support benefit designs that ensure patients do not pay more in cost-sharing than the cost of an actual drug.
  • Most plans take those manufacturer rebates and other savings and use them to reduce premiums for all their enrollees. Others use them to reduce out-of-pocket costs for specific patients who may need certain high-priced drugs.
  • Whatever the plan decides, PBM savings help them reduce the costs of drugs and overall health benefits.
  • Most consumers blame drug companies, not insurers, for higher cost-sharing.
  • As a percentage of overall out-of-pocket consumer spending, cost-sharing has actually gone down for prescription drugs to below 20%.