Pharmacy benefit managers, or PBMs, act as an intermediary between the payer and everyone else in the healthcare system. They generally make money through service fees from large customer contracts for processing prescription claims, operating mail order pharmacies, and negotiating prices with drug makers. PBMs are largely unrecognized by most employees—and even by many employers and human resource managers. But they have a tremendous impact on U.S. health care decision-making because they influence more than 80 percent of drug coverage.
Welcome to whorunsmydrugplan.com. The information on this site is intended to summarize controversial PBM practices. However, we want go beyond simply educating, we also want to motivate and guide potential efforts to change the unacceptable status quo. That can come in the form of legislative efforts at the federal or state level. On occasion it comes through litigation. Or it can occur through the senior executives (i.e. human resource managers, chief financial officers and chief executive officers) who make the decision as your health plan sponsors. You can influence those decisions by holding the PBMs more accountable to design a more transparent, efficient, cost-effective, and consumer-friendly prescription drug benefit.