Pharmaceutical costs only seem to go one direction—up. Why? The buzz in healthcare around rising drug costs lately is focused on Pharmacy Benefit Managers (PBMs). 

These middlemen manage prescription benefits for businesses and negotiate with medication manufacturers and pharmacies. But as prescription prices have soared alongside PBM profits, they’ve come under increased scrutiny from legislators nationwide.

Understanding the details of how PBMs operate is essential for plan sponsors, HR pros, and business owners to make the best decisions for their employee needs and company’s bottom line. But what you’re paying for, when, and why isn’t always clear—which makes comparing pharmacy benefit plans harder than ever. To make the right decisions to attract and retain the best talent, employers need clearer answers.

Traditional versus transparent PBMs

To help employers make sense of it all, Providence Health Plan commissioned a report on how PBMs function, profit, and contribute to high drug costs. With practical guidance, information on common fees and practices, and questions to ask any potential PBM partners, the report outlines the clear differences between a traditional, profit-focused PBM and a transparent, flat-fee structure like the one Providence Health Plan provides its clients. Unlike a traditional PBM, Providence Health Plan leads with total net costs and a straightforward fee structure that empowers businesses to make informed decisions with member needs in mind. 

Read this report to learn more about PBMs, other pharmacy benefit solutions providers, and how to compare options for your business.

Providence Health Plan takes a community-first approach to making healthcare more equitable and accessible for all. After more than 160 years, we know that when we take care of each other, we tighten the bonds that connect and strengthen us all. Learn more about Providence Health Plan.