PBMs are criticized for opaque practices, spread pricing, and rebate negotiations that don't benefit patients, leading to calls for transparency and reform. Legislative pressures and state-level ...

The system for processing prescription drug claims is reminiscent of the highly bureaucratic organizations of the mid-20th century. [18] As pharmacy claims pass through the multiple parties, each ...

Health systems rethinking role of in-house pharmacy to improve patient engagement and retain revenue from specialty and refill prescriptions.

As employers head into 2026, managing pharmaceutical costs is becoming increasingly complex, driven by a convergence of rising drug prices, increased utilization of specialty medications, and ...

Throughout 2025, Congress introduced several bills related to the pharmacy benefit management (PBM) industry. As with the 118 th Congress in 2024 (see The Focus of Federal Proposals on Pharmacy ...