What is a Pharmacy Benefit Manager?
A Pharmacy Benefit Manager (PBM) serves as an intermediary between the insurance company or third party administrator and the pharmacies. PBMs are the only subset of healthcare that remains unregulated. They determine pharmacies in the plan’s network, develop the formulary, and negotiate price rebates with drug manufacturers. Manufacturers provide rebates in exchange for having specific medications listed on the formulary.
What’s a Fiduciary PBM?
100% clinical intervention with patient & prescriber
Does not rebate, spread price, or repackage drugs
Does not sell patient information
Only allows new prescriptions on formulary when independently confirmed safe and effective
Uses independently contracted mail order passing through acquisition cost
No public stockholders
All Revenue Disclosed