A Pharmacy Benefit Manager (PBM) is a third party administrator of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. They also are responsible for developing and maintaining the formulary, contracting with pharmacies, and negotiating discounts and rebates with drug manufacturers. Today, more than 210 million Americans nationwide receive drug benefits administered by PBMs. Fortune 500 employers, and public purchasers (Medicare Part D, the Federal Employees Health Benefits Program) — provide prescription drug benefits to the vast majority of American workers and retirees. There are less than 100 major companies in this category in the US.
薬剤給付管理（PBM）は、処方薬プログラムの第三者管理機関です。PBMは、主として処方薬クレームを処理し、支払いをする責任を持ちます。彼らも、開発すること、処方集を維持すること、薬局と契約すること、製薬会社に割引やリベートの交渉をすることに対しても責任を持ちます。現在、全国で2億1000万人以上のアメリカ人は、PBMによって管理される薬剤給付を受けています。フォーチュン500雇用者と公的購入者(メディケアパートD、連邦公務員医療保障プログラム) — 処方薬給付大多数のアメリカ人労働者と退職者に提供します。米国の100未満の大手企業が、この範疇にあります。
PBMs aggregate the buying clout of millions of enrollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs through price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and the efficiencies of mail-service pharmacies. PBMs also use clinical tools aimed at reducing inappropriate prescribing by physicians, reducing medication errors, and improving consumer compliance and health outcomes.
