Pharmacy Benefit Managers 101: Who They Are and What They Do
This on-demand program is designed to provide legal counsel and others with a basic understanding of pharmacy benefit managers (PBMs). Over the past 25 years, new medications and broader insurance coverages have led to a doubling of expenditures for outpatient prescription drugs. The growth in prescription drug coverage has led to increased complexity in the delivery and reimbursement of medications. PBMs are organizations which address this complexity by impacting most aspects of the pharmaceutical supply chain. The Trump Administration’s recently announced initiative to reduce prescription drug costs – which includes proposals focusing on PBMs – recognizes the important role that these organizations play in today’s healthcare system. Consequently, it’s essential for counsel to have a basic understanding of a PBM’s role and the laws governing its activities. This program is relevant not only for PBM attorneys, but also for counsel who represent the numerous entities and individuals directly impacted by PBM operations, including health plans, employers, third party administrators, pharmacies, drug manufacturers, drug wholesalers and patients.
The one-hour course will address the following topics: (1) what is a PBM and how does it work; (2) PBM services; (3) the PBM marketplace; (4) PBM clients; and (5) the key federal and state laws impacting the PBM industry. Authored and presented by attorneys with extensive experience in the PBM industry, the course offers practical insights about the legal and business issues that impact one of the most important, and often misunderstood, segments of the healthcare industry.
Level of Difficulty: Fundamental
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