What is the primary function of a Pharmacy Benefit Manager (PBM)?

The primary function of a Pharmacy Benefit Manager (PBM) is to manage pharmacy benefit programs. This role is crucial in the healthcare system as PBMs administer prescription drug plans for various entities, including health insurance companies, employers, and government programs. They negotiate with drug manufacturers and pharmacies to secure lower prices, create and maintain formularies (lists of covered drugs), and implement cost-control measures.

By effectively managing these programs, PBMs ensure that patients have access to necessary medications while also working to contain overall drug spending for the plans they serve. They also handle claims processing and provide various services to help ensure adherence to medication regimens. While educating patients and other functions are important within the healthcare sector, they are not the primary responsibilities of a PBM.