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Patient Information

What is a PBM? What do PBMs do? How do they affect patients?
We answer pharmacy patients' most frequently asked questions.

What Are Pharmacy Benefit Managers?

And Why Should Anyone Care?

Pharmacy benefit managers (also known as PBMs, PBCs, or pharmacy benefit companies) are middlemen that sit between drug manufacturers and pharmacies. Originally created as paper pushers to process prescription drug claims,


PBMs do not manufacture or distribute medications, and they are not healthcare professionals. Their purpose is to negotiate discounts with the drug manufacturers on behalf of health insurance plans. The largest PBMs are owned by the nation's largest health insurance corporations. 

This type of vertical integration in healthcare is a conflict of interest. In their role as drug price negotiators, PBMs also determine which medications are on the "approved" or "covered" lists for the insurance company, decide how much they will charge for those medications, and determine how much they will reimburse pharmacies for each prescription they fill.


This power gives them the ability to game the system by redirecting any "savings" they negotiated back into their own pockets at every level  -- including at the pharmacy counter.

Why is that important?


PBMs constantly claim they save health plans money, or claim that if Congress passes meaningful reform that it will cause insurance premiums to rise. Nothing could be further from the truth.

As subsidiaries of giant publicly-held healthcare corporations that rank higher than pharmaceutical companies in the Fortune 500 list, PBMs' main focuses are corporate profits & ensuring high returns for their shareholders  - not patients. 

Pharmacy benefit managers have a place in the healthcare system - in their original purpose as administrators. Unfortunately, corporate greed borne of vertical integration has created unregulated, unethical monsters that prey on every facet of the system, including patients and taxpayers.


By exploiting their position within giant corporations that also include insurance, pharmacies, and provider networks, any "savings" PBMs claim to generate are funneled back into their own companies' pockets as revenue  - which means PBMs' premium increase threats are simply an effort by their parent corporations to compensate for the loss of a revenue stream due to patient-centered legislation.

Pharmacy Benefit Managers & Their Parent Health Insurer Corporations


"For too long, the largest PBMs have been able to use their dominant market position to crush competition by creating a monopoly-like environment that works against patients, consumers and taxpayers."

PUTT Board of Directors,

official statement to the Federal Trade Commission

Pharmacy Patient FAQ

Because We Are ALL Patients

Are All PBMs Bad?

No. Not all PBMs operate in an anticompetitive, unethical manner.


The largest PBMs that control the majority of the market are known as traditional PBMs. They operate in a black box of unregulated secrecy that allows them to overcharge governments and employers, bully patients, and run their competitors (pharmacies they do not own) out of business.


Transparent or "pass-through" PBMs are smaller companies that provide the same services as traditional PBMs but without unnecessary fees, pricing games, and shady business practices. These honest PBMs are actually there to lower prices for patients and the health plans they represent - unlike their traditional PBM counterparts.

Support PUTT in the Fight Against PBM Abuse of America's Patients

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