Although pharmacy benefit managers (PBMs) have been part of American health care since the 1970s, how they make money is a mystery for many people outside of the industry. Calls for transparency have resounded in the media and at all levels of government with growing frequency in recent years. Often, pharmacy benefit managers respond by touting their transparent programs, but within the industry, “transparency” can mean many different things, making it a shell game.
My colleagues and I realized that the opacity of pharmacy benefit managers was bad for patients — and for business. So, we started BeneCard PBF, a pharmacy benefit manager that focuses on people, not profits. Over the last 10 years we have grown the company by defining transparency in a meaningful way that serves patients’ needs, not through mergers and acquisitions, which run the risk of taking our focus off patients in favor of growing company profits.