Brian Anderson of Milliman Warns That Mandating PBM Transparency Could Backfire | PBMI Innovator

As more folks push for greater transparency in pharmacy benefit management (PBM), one expert is warning that taking the same approach for everyone could create challenges.

Brian Anderson, MBA, a principal and consulting actuary at Milliman, is one of this year’s winners of Managed Healthcare Executive’s inaugural PBMI Innovator Award. The honor recognizes leaders who are reshaping the pharmacy benefits space in innovative and meaningful ways.

Anderson, who works closely with large clients and PBMs, believes transparency is essential—but sees risks in how it's being pursued.

“We get full transparency,” Anderson said. “We get access to all the claims data. We’re able to look at all the network and manufacturer agreements, and that’s by building trust in the industry and treating people fairly.”

At Milliman, Anderson has built out specialized teams—including audit, request for proposal (RFP) and financial analysis groups—that operate independently under strict protections like NDAs. This structure allows his team to access sensitive data that many others in the industry cannot.

He credits that access to long-term relationships, a clear separation of roles and a commitment to respecting partners across the pharmacy ecosystem.

However, he noted that transparency in PBM contracts and claims data isn’t the norm for everyone—and that differences in how firms operate may limit access. Some firms, for example, may burn bridges or tie their services to financial contingencies, reducing trust and visibility.

What frustrates him most is the inconsistency in how society demands transparency.

“We’re asking for transparency in a consumer industry that’s different than other industries,” he said. “We don't ask for that level of transparency and other things that are the goods that we purchase in our life. We're not asking it for a lot of the health other medical fields and other areas."

Anderson said he supports giving clients full access to their PBM contracts and claims data but worries that if transparency is mandated without nuance, it could backfire.

“Adding transparency adds cost,” he said. “You’re going to add a lot more overhead, a lot more reporting responsibilities. So there could be a backfire here, if we don’t find the right solution.