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A Pharmacy Benefit Manager is an organization that manages the “paperwork” for employers, related to filling prescriptions through a pharmacy. PBMs have a network of retail, specialty and mail-order pharmacies like CVS, Walmart, even mom-and-pop drugstores, at which a person may fill their prescription.
Simply, because the PBM you’re using is probably charging more than is needed and not always offering the best products available. Most likely this is due to the way they are set up and managed. They are beholden to shareholders and responsible for meeting specific margins. And due to the lack of knowledge by employers.
We do a lot, but primarily we lower your prices by creating a 100-percent transparent PBM agreement that separates your pharmacy benefits from your medical benefits while continuing to work with your current insurance rep. And we set up a pharmacy network across the U.S. is the same or similar to your current network.
— John Mansour, PharmD