PBM Definition: Pharmacy benefit managers, or PBMs, are companies that manage prescription drug benefits on behalf of health insurers, large employers and other payers. By negotiating with drug manufacturers and pharmacies to control drug spending, PBMs have a significant behind-the-scenes impact in determining total drug costs for insurers, shaping patients’ access to medications and determining how much pharmacies are paid.

When PBMs originally came about, they used their power to negotiate drug prices at lower costs and pass the savings on to their members. Once PBMs grew, consolidated and added opaque layers like GPOs, industry problems increased. Now, over 75% of the market is run by 3 large PBMs. Currently, these traditional PBMs keep pricing a secret, focus on chasing profits through rebates and spread and all clarity that once existed is lost. AffirmedRx is on a mission to change this.

Now more than ever, employers require targeted and timely insights to guide decisions and shape pharmacy benefit solutions. Aligning with a PBM like AffirmedRx will ensure market competitiveness and an ongoing heavy-weight in your corner, keeping an active finger on the pulse of your plan’s performance.

“Never before have I felt like I could pick up the phone and not only reach out directly to the PBM with patient specific requests but also be able to speak to someone knowledgeable and with clinical expertise. AffirmedRx has proven to me and to my patients that the patient is at the center of their focus.”

– Feedback from a pharmacist within a providers office