New PBM programs bypass insurers to offer drug discounts directly to consumers

Pharmaceutical benefit managers and tech startups are responding to underinsurance and the onslaught of high-deductible health plans by cutting out insurers in the quest to help patients lower their prescription drug costs.

Two PBMs have launched discount programs for patients to use outside of any insurance coverage they might have. It’s a notable contrast to PBMs’ main business serving as third-party administrators of prescription drug coverage for insurers and employers.

These efforts come as a budding industry has sprung up around helping consumers and employers rein in prescription drug costs. Startups like Blink Health and RefillWise offer pharmacy cards that provide consumers with negotiated discounts if they don’t use their prescription coverage, while some insurers and pharmacy benefit managers, along with tech firm Castlight Health, are attempting to allay consumer and employers’ concerns about drug costs by building apps that offer price transparency to physicians or patients.

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