Reforming The Rx Rulers: A New Script For PBMs

09 Apr 2025

• By Andrew Cox

As PBMs shift to value-based contracts, federal and state efforts seek to reduce drug costs, increase transparency and tackle anticompetitive practices.

Committee tasked with proposing major federal spending cuts. Will it have time for PBM reform? (Shutterstock)

Having evolved from claims processors to drug cost administrators, pharmacy benefit managers (PBMs) have become giant players in the health care industry by managing drug costs, enhancing medication adherence and ensuring quality care for patients.

Currently, PBMs manage prescription drug programs for health plans, employers and government programs like Medicaid and Medicare Part D. They...