MHE December 2022

A list of some of the smaller PBMS who are taking on the big three or finding a niche in the industry.

This isn’t the first time pharmacy benefit managers (PBMs) have been ensnared in controversy. PBMs were first created in the 1960s to help insurance companies manage and administer claims for prescription drugs. Over time, they took on the roles of claims adjudication, rebate negotiation and benefit design.

Smaller and midsize pharmacy benefit managers are taking on Optum Rx, CVS Caremark and Express Scripts. They say they have better technology and are more transparent about their pricing.

The researchers have several suggestions for how harm from screening should be reported in screening guidelines.

Smartwatches such as the Apple Watch could save insurers money if they detect atrial fibrillation early, but false alarms may be an issue.

Cuban’s Cost Plus Drugs business has entered into agreements with Capital Blue Cross and Rightway.