PBM Revenue Generation Secrets

This document is about how the prescription benefit manager (PBM) industry has been consolidating, leading to a lack of objective oversight and PBMs exploiting contract language to generate more revenue. It discusses common contract components that differ between PBMs, how rebates can misalign PBM incentives, and various PBM tactics like using delayed MAC pricing and reclassifying generics as brands. The presentation emphasizes the need for employers to carefully review PBM contracts, track unit costs, and secure full audit rights to protect themselves against these practices.