Milliman’s Brian Anderson: PBM Market Still Offers Options Despite Consolidation Concerns | PBMI Innovator

Brian Anderson, MBA, principal and consulting actuary at Milliman, is one of six honorees recognized by Managed Healthcare Executive’s inaugural PBMI Innovator Award for driving change in the evolving pharmacy benefit landscape.

Although concerns about consolidation in the pharmacy benefit manager (PBM) industry are on the rise, Anderson shared in an interview with MHE that he sees a more complex picture—one that still holds potential for innovation and improvement.

He shared that while vertical integration across large PBMs was expected to bring better coordination between medical and pharmacy data, those improvements have yet to fully materialize.

“We’re just not seeing it come out,” Anderson said. “There is opportunity there, if it’s played right.”

For example, Anderson pointed out that many of the delays patients face—such as prior authorizations or appeals—could be more efficiently managed with better use of existing medical claims data. The potential exists for integrated PBMs to deliver more holistic patient care, but execution still lags behind expectations.

He also noted that while some large PBMs dominate the conversation, employers and plan sponsors still have a wide range of vendors to choose from.

“You can easily do a PBM (request for proposal) RFP and have more than 20 vendors that are qualified to provide services,” he said. “So there’s plenty to choose from. We help our clients navigate that.”

He shared his belief that the power of market choice remains strong and that consolidation has not completely limited options. Though large PBMs can offer financial advantages through their purchasing power, Anderson says utilization management must also be part of the equation.

Overall, Anderson remains optimistic.

“I’m not too concerned,” he said. “I feel like the consumer market will shake itself out at some point.”

As one of the award recipients, Anderson is being recognized not just for understanding the challenges of today’s PBM landscape, but also for helping clients find strategic paths forward—no matter how complex the marketplace becomes.