Upholding the PBM Fiduciary Duty: A Patient-Centric Approach

In the complex landscape of health care, pharmacy benefit managers (PBMs) play a crucial role in managing prescription drug benefits for millions of Americans. However, their market placement, fiduciary responsibilities, and clinical focus have often been a subject of debate.

AffirmedRx has a unique approach to the PBM fiduciary duty—we go beyond the conventional model by placing Patients over Profits with a dedication to making a positive impact on the many aspects of patients’ health care journeys.

PBM Market Placement

Traditional PBMs have frequently faced criticism for their opaque business practices, complex rebate structures and conflicts of interest. These factors have raised concerns about whether PBMs prioritize financial gains over the well-being of patients.

Market placement plays a huge role in PBM fiduciary duty. Since 80% of the market is controlled by the “Big 3” PBMs, they are not incentivized to change the market they are thriving in, regardless of the damage it poses to patients and health care as a whole.

We’ve positioned AffirmedRx in the market as an entity committed to achieving both social and financial objectives, emphasizing transparency and patient-centricity as a Public Benefit Corporation (PBC).

PBM Fiduciary Duty

The concept of PBM fiduciary duty is of paramount importance. As intermediaries between health plans, pharmacies and pharmaceutical manufacturers, PBMs must act in the best interests of the patients we serve.

AffirmedRx fully embraces this fiduciary responsibility by establishing a strong ethical framework that places patients’ well-being as the top priority. We aim to optimize medication outcomes, enhance affordability and ensure patient access to necessary medications.

Additionally, we hold ourselves accountable through AffirmedRx’s executive compensation structure that ensures ethical business practices. For all members of the AffirmedRx C-suite, the board has the ability to take back up to 95% of their total compensation and incentives if it is found that they are not providing full disclosure of pricing and terms to clients.

PBM Clinical Focus

While PBMs are primarily known for managing drug costs, AffirmedRx recognizes the importance of clinical focus. We understand that medication management is not solely about cost containment but also about improving health outcomes. This is why we ensure the lowest net cost and highest clinical value options are available for our members.

It is not lost on us that 37% of U.S. adults skip filling their prescriptions, which results in 125,000 preventable deaths each year. The number one reason that patients skip their medication is due to cost. When PBMs drive to a higher cost, that directly impacts patients’ adherence. Every day we are working to negate those statistics by building a patient-centric PBM business model.

Holding the Pharmaceutical Industry Accountable

While market placement does mean a lot in the PBM industry, the AffirmedRx team refuses to let the “Big 3’s” jurisdiction over the market win. We aim to exemplify the possible transformation occurring within the industry. By adhering to the principles of the PBM fiduciary duty, we are redefining the role of a PBM, placing patients at the forefront.

Through our PBC status, we demonstrate a commitment to ethical and transparent practices while striving to improve health outcomes, medication access and affordability. As health care continues to evolve, AffirmedRx serves as a beacon of patient-centered care within the PBM landscape, inspiring others to prioritize the well-being of Patients over Profits.

Connect with our team today to learn how our members receive premier care while saving on their pharmacy benefit plans.

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