How a PBM works

Express Scripts, and other PBMs, are essential partners across the drug supply chain—helping drive down drug spend and improve medication access for clients and customers.

Today, high prescription drug costs are often incorrectly blamed on PBMs

But facts are facts: it is not PBMs but others in the supply chain, starting with pharmaceutical manufacturers, who are solely responsible for setting and raising drug prices. In fact, list prices have continued to significantly increase year-over-year.

Rising drug price inflation

636 medications had their prices increased by pharmaceutical manufacturers in the first week of January 2022
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Most top 25 Medicare Part D drugs had price increases above inflation in 2020

Most top 25 Medicare Part D drugs had price increases above inflation in 2020.
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Without PBMs, drug costs would go up…

$1,040 per person

annual savings for payers and patients1

Per $1 spent

on their services, PBMs reduce health care costs by $102

$1 trillion

anticipated savings for plan sponsors and consumers from 2020-2029; saving Medicare Part D and Medicaid plans and beneficiaries $445B and $46B, respectively3

1 billion

anticipated medication errors that PBMs will prevent over the next 10 years1

behind-the-scenes

PBMs work to deliver value for clients and consumers— partnering seamlessly at every step of the drug supply chain

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How PBMs create value across the drug supply chain to provide lower premiums, expand medication access, fund wellness plans, and reduce medication cost at point-of-sale for members.

PBMs like Express Scripts help clients put money back into consumer wallets

PBMs keep other players in the drug supply chain in check.

PBMs lower the cost of generics, branded and specialty drugs to deliver more savings and provide greater access to medications and life-saving therapies for consumers and clients.

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PBMs save private sector employers patients $625 per year on prescription drug costs: up to $75 on generics, $406 on brands, and $144 on specialty drugs.

Sources

  1. PCMA, “The Value of PBMs”
  2. Ibid
  3. PCMA, “PBMs Will Save Health Plan Sponsors and Consumers More Than $1 Trillion On Prescription Drugs”