Published March 20, 2018
Medicaid programs increasingly rely on Pharmacy Benefit Managers (PBMs) to manage drug benefits for Medicaid beneficiaries, whether they have health plan or fee-for-service coverage. A new UnitedHealth Group research report finds that pharmacy benefit management can save Medicaid drug programs over $100 billion.
PBMs generate significant savings for Medicaid by:
Nationally, PBMs saved Medicaid $6 billion in 2016. These savings represent only a portion of the potential savings achievable through optimal use of pharmacy benefit management in Medicaid. If all states were to fully utilize these PBM tools and capabilities, PBMs could save Medicaid more than $100 billion.
The report goes on to show that over the next decade, optimal use of PBM capabilities in Medicaid by all states would result in: