In the last few years, pharmacy benefit managers, often referenced as PBMs, have taken on an increasingly prominent role in PACE pharmacy. To fully understand the role of PBMs in PACE pharmacy, first consider the role of pharmacy benefit managers more broadly. The American Pharmacists Association defines a pharmacy benefit manager as a third-party administrator of prescription drug programs, working with companies to maintain or reduce the pharmacy expenditures of plans without sacrificing healthcare outcomes. The role of PBMs in PACE pharmacy is more specific—they support PACE Plans in navigating the complexities of Medicare Part D plan participants. Working with the pharmacies, PBMs play three main roles in PACE programs.
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