Author: Hassan Qureshi

Pharmacy benefit managers (PBMs) are compensated third-party administrators of insurers’ and employers’ prescription drug coverage. They offer various services, including formulary development and maintenance, claim processing, and discount and rebate negotiations between payers and manufacturers. PBMs administer plans for millions of Americans covered by various types of health insurance. Including commercial health plans, self-insured employer plans, Medicare Part D plans, state government employee plans, and Medicaid managed care organization (MCO) plans. Pharmacy benefit managers (PBMs) first emerged in the 1970s and acquired increased popularity with the passage of the 2003 Medicare Modernization Act, which created Medicare Part D. Historically, PBMs…