What if PBM’s disappeared?

  • PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims.
  • While drug distributors convert 45% of their gross profit to EBITDA, and insurers and pharmacies around 30%, PBMs convert 85%.
  • Just three PBMs control eighty percent of the prescription market, driving enough revenue to put them way ahead of all drug manufacturers on the Fortune 500.
  • Express Scripts, by some estimates, the company’s profit per prescription has increased an average of 38% every year between 2003 and 2016. That kind of growth has landed Express Scripts at number 22 on the Fortune 500 list in 2017.

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