CURRENT PBM TRANSPARENCY LEGISLATION
WHAT IS A PBM?
Pharmacy Benefit Managers, or PBMs, are third-party entities that contract the management of pharmacy benefits for government programs and employer-sponsored health plans. PBMs develop and maintain drug formularies, contract with pharmacies, negotiate rebates and contracts with manufacturers and oversee the processing and payment of pharmacy benefit claims.
Recently, many healthcare professionals and advocates have become concerned that the services offered by PBMs do not contribute enough positive value to merit the heavy costs and impact on the overall price of health care.
Below are state and federal level PBMs that NICA either supports or opposes. Click on a colored state to learn more.