Pharmacy benefit managers: a model for Medicare?
This issue brief uses large employer experiences with pharmacy benefit managers (PBMs) to shed light on their potential as Medicare outpatient drug benefit administrators. PBM management techniques and typical employer approaches are discussed, as well as employer perspectives on PBM strengths and weaknesses and lessons learned. Considerations for Medicare policy are also examined. Information is based on a literature review and conversations and telephone interviews with employers, PBM industry executives, and benefit consultants. This brief builds on previous National Health Policy Forum PBM industry analysis; in particular the October 1999 forum and issue brief "The ABCs of PBMs."
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D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008329:Managed Care Programs / Q000458:organization & administration; D006278:Medicare; D017146:Models, Organizational; D014481:United States