6 ways PBMs influence the drug market

Pharmacy benefit manufacturers complicate the drug pricing system and drive up out-of-pocket costs for patients, according to a new report from Pacific Research Institute.

For the report, the Pacific Research Institute reviewed existing literature surrounding the role of PBMs and their impact on the U.S. pharmaceutical market.

Here are six ways PBMs affect the drug market, according to Pacific Research Institute.

1. PBMs create pricing uncertainty by incentivizing higher list prices for drugs that allow for large rebates and discounts.

2. This large discrepancy between list prices and transaction prices results in higher patient copays than necessary.

3. Higher list prices and copays may push Medicare Part D patients into the coverage gap faster.

4. PBMs enact costly — and often unknown — fees, which leads to substantial revenue uncertainty and volatility for pharmacies.

5. PBMs also increase their share of gross expenditures at the expense of pharmacies and manufacturers.

6. By controlling drug formularies, PBMs hold too much influence on the treatments patients can access.

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