Decoding the Enigma of Pharmacy Benefit Managers (PBMs) in US Healthcare

Pharmacy benefit managers (PBMs) are being blamed for high prescription drug prices in the US. PBMs negotiate discounts with drug manufacturers and manage insurance benefits for prescription drugs, dictating which drugs are covered by insurers and what costs patients will face when they fill their prescriptions. The Senate is set to impose new rules on PBMs as part of forthcoming prescription drug legislation, requiring them to be more transparent about their business and cracking down on some of their moneymaking practices. However, experts caution that reforming PBMs doesn’t fundamentally change a US pharmaceutical market that gives companies carte blanche to set whatever list prices they want for new drugs.