Who benefits from pharmacy benefit managers? / Yankun Jia, Richard J. Gentry, and Becca Treat.

Format:

Book

Author/Creator:

Jia, Yankun, author.

Gentry, Richard J., author.

Treat, Becca, author.

Series:

SAGE business cases.

SAGE business cases

Language:

English

Subjects (All):

Health insurance--United States--Case studies.

Health insurance.

Physical Description:

1 online resource : illustrations.

Place of Publication:

London : SAGE Publications: SAGE Business Cases Originals, 2026.

Summary:

This case explores the complex and controversial role of Pharmacy Benefit Managers (PBMs) in the U.S. healthcare system, using Express Scripts as a central example. It details the core PBM functions and examines how Express Scripts achieved its significant market share through aggressive M&A activities, despite facing antitrust scrutiny. The case reveals that the PBM business model, which relies heavily on scale, negotiated rebates (often lacking transparency), and vertical integration (with insurers and owned pharmacies), may be the driver behind increasingly unaffordable drug prices. The key question to be answered is how managers of PBMs can develop a sustainable strategic framework to help their companies adapt to the future of healthcare markets and reshape the competitive dynamics.

Notes:

Description based on XML content.

ISBN:

979-83-488-5357-0

OCLC:

1569208599

Publisher Number:

T301202