What does PBM stand for in pharmacy practice?

In pharmacy practice, PBM stands for Pharmacy Benefit Manager. A Pharmacy Benefit Manager is a crucial entity in the healthcare system that manages prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, and large employers. PBMs play a role in negotiating drug prices with manufacturers, managing pharmacy networks, and implementing prescription drug plans. Their primary goal is to control prescription drug spending while ensuring that patients have access to necessary medications.

The importance of PBMs in managing drug formularies, which determine which drugs are covered by insurance plans, also facilitates cost-effective medication use. By negotiating discounts and rebates from pharmaceutical companies, PBMs help manage overall drug costs for both insurers and patients. This understanding is pivotal for pharmacy practice professionals, as they often interact with PBMs regarding drug formulary placements and patient medications.