Pharmacy benefit management (PBM)

The drug price middlemen

Illustration of falling pills and coins
Illustration: Sarah Grillo/Axios

We keep mentioning “middlemen” as part of the complex, expensive drug supply chain. They’re actually called pharmacy benefit managers, or PBMs, and their role in the system is both incredibly important and incredibly opaque.

Express Scripts to open up mail-order pharmacy network

Medication bottles on a table.
Express Scripts mails millions of prescriptions every year. Photo: Scott Varley/Digital First Media/Torrance Daily Breeze via Getty Images

Express Scripts sent a notification this month to pharmacies saying its networks will expand to include "pharmacies predominantly engaged in mail-order practice" by the first quarter of 2019.

Why it matters: Express Scripts, which negotiates drug prices for 80 million Americans, may be opening the door for any mail-order pharmacy — including Amazon's newly acquired PillPack — to get full access to its large network, as long as the pharmacy agrees to Express Scripts' contract terms.

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