A pharmacy benefits manager (PBM) is a third-party administrator (TPA) of prescription drug programs. PBMs are contracted by organizations to provide prescription drug benefit management for their employees.
The cost of prescriptions is the fastest growing segment of healthcare cost in the United States, faster than hospital and physician costs combined. The NIH and GAO estimate that in 2021, prescription drug expenditures in the United Stated were approximately $576.9 billion, representing roughly 17.5% of the overall dollars spent on personal healthcare services. This is up from roughly 7% in the 1990’s.