STATE NET® THOUGHT LEADERSHIP SERIES

The Role of Pharmacy Benefit Managers

Pharmacy benefit managers (PBMs) are companies that contract with health insurers and employers to manage the prescription drug benefits for millions of Americans. They function as third-party administrators of prescription drug coverage, providing a wide variety of services that range from negotiating prices with drug companies to processing claims from insureds.

States Turn Attention to PBMs

By late-2023, all 50 states had passed at least some legislation to regulate PBMs, according to the National Academy for State Health Policy. Most of these laws brought PBMs under state regulatory authority and established some basic regulatory framework for their operations. But the heat was turned up over the past year.

In August 2024 the State Net Capitol Journal™ reported that more than 100 bills dealing substantively with PBMs had been considered in 26 states at that point of the 2023-2024 legislative biennium, and at least 13 of those measures had been enacted

Download the latest State Net Capitol Journal thought leadership article to learn more.