What is a primary objective of a pharmacy benefit manager?

• A. Improve Patient Satisfaction
• B. Optimize Economic Outcomes of the Pharmacy Benefit
• C. Expand Hospital Networks
• D. Increase Drug Prices

Answer: (B)

The primary focus for a pharmacy benefit manager is to control and optimize the economics of the pharmacy benefit. A PBM works to lower the net cost of medications by negotiating rebates and discounts with manufacturers, designing formulary tiers to steer utilization toward cost-effective options, and employing utilization management tools such as prior authorization and step therapy to ensure appropriate, evidence-based use. It also contracts with pharmacies to secure favorable prices and handles claims processing. All of this centers on reducing costs for the plan and its members while preserving access and quality of care.

While patient satisfaction and access are important, they aren’t the main objective of a PBM. Expanding hospital networks is outside the core scope of pharmacy benefit management, and increasing drug prices would undermine the goal of cost optimization.