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Pharmacy Benefit Managers


Once prescription drugs became more expensive, employers and insurers began to look at ways to manage prescription drug plans more effectively. The result was that many employers now incorporate managed pharmacy programs into their health care benefits. Pharmacy Benefit Managers (commonly referred to as "PBMs") are companies that adminster the managed pharmacy programs. They work with employers to reduce the cost of drugs purchased by members and to improve the prescribing and dispensing process.

Pharmacy Benefit Managers tend to offer a variety of services which can include, among other services:

  • A prescription drug card program.
  • Filling prescriptions by mail.
  • A drug utilization program.
  • Education for the consumer and doctors.

Employees who participate in a PBM are required to have their prescriptions filled by a network pharmacy except for emergencies. Pharmacies join networks and provide services at reduced rates in exchange for a built-in volume of business.

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