PBM Resources

Pharmacy Benefit Managers, often known simply as "PBMs," are largely unrecognized by most employees—and even by many employers and human resource managers. But they have a tremendous impact on U.S. health care decision-making because they influence more than 80 percent of drug coverage.

The information in this section is intended to summarize controversial PBM practices, provide a record of NCPA's efforts regarding PBMs as well as any bills that have been introduced or any laws that have been passed on a state level regarding their practices.

Don't let the insurance company middlemen inflate costs and reduce the quality of health care. Support Federal and state efforts to regulate PBMs, as well as halt mandatory mail order in its tracks. Model state legislation, a listing of state laws concerning PBMs, a listing of lawsuits involving them and other resources are available for your use.

"They aren't loyal customers. They're hostages, and they don't like it."

J.D. Power and Associates official describing patients in mandatory mail order pharmacy plans, Drug Topics article, Mar. 2010.