Pharmaceutical drug prices continue soaring up and contribute significantly to total
healthcare expenditure worldwide. The cost of drugs has risen more than any of the
healthcare expenditure. As per the insurance consultants at Milliman, drug costs were
merely 16% of the overall health costs in 2015, which rose by 102% over a decade and
accounted for around 14% in 2015. Rising drug prices and increasing consumer spending
on prescription drugs drives demand for pharmacy benefit managers (PBMs). The pharmacy
benefit management system is operated by third party administrators (TPAs) who act
as a liaison between pharmacists, insurance providers (payers), and drug manufacturers.
There are established companies offering these services who aid in reducing drug prices
by negotiating with retail pharmacies and drug manufacturers. Patients who have enrolled
in various health plans and those uninsured can get the benefits of pharmacy benefit
management system. Health plans collaborate with the pharmacy benefit managers to
offer medications at a lower price than those available at retail pharmacies.
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