If you have never heard of a pharmacy benefit manager, you are not unique among most Americans. What if I told you there are entities within the American healthcare system that essentially act as middlemen who transfer money between drug manufacturers and health insurers, employers, and pharmacies but that produce no products, yet generate billions of dollars in annual revenue? These are pharmacy benefit managers.

While that may be an oversimplification of the role of pharmacy benefit managers, or PBMs for short, within the American healthcare system, the role of PBMs are little known and even less understood. PBMs may be obscure entities, at least to the average American not ingrained in the healthcare industry. However, the once hidden middleman has been recently thrust into the spotlight as the subject of much controversy surrounding high drug prices and mega mergers.  This article briefly explores the role of PBMs and the current controversy that surrounds these drug behemoths. 

To read the full version of this article written by Duane Morris attorney Bradley A. Wasser, please visit The Wharton Healthcare Quarterly website.