When a company provides a pharmacy benefit to its employees, the company itself rarely (if ever) handles the details of the program. A PBM provides a number of services in seeing that the benefit actually operates smoothly. PBMs rely on three basic strategies to generate profits in providing those services. The first is rebate retention. The plan sponsor pays the list price and the PBM takes some or all of the rebates from the pharmaceutical manufacturers. The second is spread pricing, in
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