Pharmacy benefit managers (PBMs) are the “middlemen” between your plan and the drug manufacturing community. They’re supposed to help you contain costs. Today’s headlines call into question whether conflicts of interest exist between PBMs and drug makers, such as rebates collected by PBMs, which enable higher-cost products to thrive in the marketplace rather than allowing competition to drive down the employer’s cost.
Massive consolidation leaves 80% of the market in the hands of three Fortune 100 focused firms. As wise consultants, we know all the industry players, even if some don’t have instant name recognition for the average person. We also know the right questions to ask PBMs to elicit whether they have the clinical focus and administrative flexibility to complement our clients’ interests. No matter who the PBM is, Doyle Alliance Group works to ensure you have an appropriate contract designed to achieve positive results from both a cost and service perspective.