Further rumblings against pharmacy benefit managers

Pharmacy benefit managers (PBMs) got a start by promising their customers huge savings when ordering medications on behalf of their customers. It appears that a focus on percentage discounts (rather than absolute costs) drove drug manufacturers to raise their list prices, so that PBMs can tout greater savings. Pricing models became more complex and in many cases, patients end up paying more for medications. KFF Health News profiled someone whose job was to educate others on the pitfalls of PBMs and who ended up bringing a lawsuit against her employer -- a drug manufacturer.

In terms of good news, there is a new type of PBM on the market, which simply adds a processing fee. As highlighted in the article, those entrants appear to be gaining some traction, as evidenced by several large companies and the state of Connecticut switching over to these newer PBMs. It might still be a decade or more before incumbent PBMs vastly change their business model.