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Pharmacy Benefit Managers (PBMs)

How These Companies You’ve Never Heard of Affect the Price of Your Prescription Drugs and Access to Treatment 

Even in the face of the recently increased attention to the impossibly complex drug industry following the growing public outcry over rising drug costs, there is one industry player that has managed to stay in large part under the public’s radar: Pharmacy Benefit Managers (PBMs). Acting as intermediaries between insurers, manufacturers, and pharmacies, PBMs play a uniquely central role in the prescription drug market, handling everything from negotiating prices with drug manufacturers and setting patient copay amounts to determining which drugs are covered by which insurers. And yet, despite their undeniable significance, PBMs and their effect on drug costs have managed to go largely unnoticed by the vast majority of Americans, allowing them to quietly influence not only prices and ultimately the amount patients pay for their prescriptions but also which drugs are available and accessible to the public.


  • Drug Flow
  • Services
  • Cash Flow
  • Rebate

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Drug Supply Chain

  • Manufacturer

  • Wholesaler

  • Pharmacies

  • Patients


Drug Benefit Program

  • Patients

  • Insurer

  • PBM

  • Pharmacies


The Rebate System

  • Manufacturer

  • PBM

  • Insurer

  • Patients