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The Economics of Benefit Management in Prescription-Drug Markets

BY | January 20, 2025

On behalf of drug plans, pharmacy benefit managers (“PBMs”) coordinate patient prescription utilization, process claims, and negotiate plan savings from other actors in the healthcare supply chain. Their contracts with…

On behalf of drug plans, pharmacy benefit managers (“PBMs”) coordinate patient prescription utilization, process claims, and negotiate plan savings from other actors in the healthcare supply chain. Their contracts with manufacturers and retailers tying discounts to utilization create significant economic value and expand access in the prescription-drug market. By delivering patient-groups to providers, the contracts the create competition where otherwise little would exist.  Providers, in t

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