Pharmacy Benefit Managers
A Pharmacy Benefit Manager (PBM) is a third-party administrator that manages prescription drug benefits for health plans and employers. In addition to processing claims, PBMs negotiate drug prices, create lists of preferred medications and pharmacy networks, and establish cost-containment protocols. PBMs play a key role in the healthcare system.
AiArthritis Position Statement On Pharmacy Benefit Managers
The market dominance of Pharmacy Benefit Managers allows them to greatly inflate prices and restrict access for patient medications
Patient Written Glossary of Terms
Frequently, everyday terms when navigating a diagnosis of an AiArthritis Disease—such as "payer"—can lead to confusion. Therefore, we have developed a glossary to assist!
Discover Patient Journeys With Pharmacy Benefit Managers In Our Video Library!
The Patient-Instructed Video Library
The Patient-Instructed Video Library was created to help our community gain a deeper understanding of critical issues that affect access to health care. The goals of this initiative are to educate, inspire fellow patients to share their experiences, and empower our community to take action in addressing access-related challenges.
What are PBMs? (Ray's Perspective)
Join Ray, who has psoriatic arthritis, as he shares insights on Pharmacy Benefit Managers (PBMs) and their role in healthcare. Learn how PBMs affect medication access, affordability, and care quality for patients.
PBM Transparency & Reforms - Why Should Patients Care? (Michael's Perspective)
Michael Guadalupe, AiArthritis Volunteer Coordinator and psoriatic arthritis patient, discusses how Pharmacy Benefit Managers (PBMs) control prescriptions and pricing.
PBM Transparency & Reforms - Why Patients Should Care
Listen as Ray discusses Pharmacy Benefit Managers (PBMs) prioritizing profits over patient care. He highlights transparency issues, actual savings from discounts, and the need for regulatory reforms.
PBM Transparency & Reforms Patient Story: Kelly's Perspective
Kelly Conway, who has autoimmune arthritis, as she shares her struggles with pharmacy benefits managers (PBMs) to access vital medication. After two months of delays, she highlights the challenges patients face and the need for advocacy.
PBM Transparency & Reforms Patient Story: Britt's Perspective
Join Britt as he shares his experiences managing severe psoriasis, the challenges with pharmacy benefit managers (PBMs), and navigating insurance for effective treatment.
Learn More By Exploring Our Video Library
Did you know that access to healthcare and treatments is frequently tied to policies like government healthcare systems and insurance companies? Recognizing these influences and sharing YOUR experiences with legislators to illustrate the need for policy change is crucial!
Share Your Pharmacy Benefit Manager Experience
Would you share your experience with us? We’d like to hear how you navigated challenges in obtaining healthcare or treatments. What obstacles did you face, and how have they shaped your journey? Your insights could be invaluable to others in similar situations.
Class Is In Session! Pharmacy Benefit Manager (PBM)
About The Classroom: Lead instructors, including our CEO Tiffany, who has non-radiographic axial spondyloarthritis (nr-axSpA) and is a former award-winning college instructor, will collaborate with Class Discussion Leaders living with our diseases to host engaging webinars and AiArthritis Voices 360 Talk Show segments.
Pharamcy Benefit Manager (PBM): Most have experienced this health insurance protocol that requires us to fail a cheaper drug before being allowed to access the one prescribed by our doctor. Learn more about this issue & what you can do if it happens to you. In collaboration with The National Psoriasis Foundation
How To Get More Involved!
Ready to deepen your involvement? Share experiences to support our fight for change with AiArthritis—join us for co-writing letters, virtual Field Trips, or become an inaugural AiAdvocate in our policy leadership program!
Join the Knowledge = Empowerment Program
A virtual, patient-led classroom approach designed to help patients understand legislative issues affecting treatment access and connect them with opportunities to advocate for change.
#WTHellth?!
Share your frustrations with the healthcare system using #WTHellth. Prefer privacy? Submit a written rant anonymously through AiArthritis’ RANT! program, selecting the #WTHellth category.
