Pharmacy benefit managers (PBMs) have a unique opportunity to promote health and generate value in the healthcare system. Today, PBMs are largely evaluated on their ability to control costs rather than improve health. Pharmacy benefit managers should be evaluated along 3 dimensions in which they can increase value: (1) use of cost-effective medications, (2) timely initiation of appropriate medication therapy, and (3) adherence to that therapy. Value creation requires the development of integrated data systems, stronger partnerships with patients and physicians, and improved measurement and reporting of results. Incentives for PBMs to promote value should drive innovation and improve health outcomes.
Shrank, William HPorter, Michael EJain, Sachin HChoudhry, Niteesh KK23 HL090505-02/HL/NHLBI NIH HHS/United StatesK23HL090505-01/HL/NHLBI NIH HHS/United StatesResearch Support, N.I.H., ExtramuralUnited StatesThe American journal of managed careAm J Manag Care. 2009 Feb;15(2):87-93.