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What does a PBM do? Use this handy guide to explain

We recently saw a well-done explanation of how PBMs interact with the patient’s journey and wanted to share it with our readers.

The short article was created by Pharmaceutical Care Management Association (PCMA), the industry’s representative organization in Washington.

While most of us are deeply familiar with that journey, it’s easy to forget that, to healthcare consumers, that process may not be as clear as it could be.

In the article, the reader is walked through six discreet stages, from doctor’s visit through medicine dispensing and beyond. 

If you regularly come in contact with patients, some of whom may be struggling with who’s who in their healthcare process, you might want to bookmark this short article about what PBMs do for patients for sharing.

And for a deeper dive into how PBMs can do better, check out these articles from VativoRx:

A New 340B Pilot Signals a Shift in Strategic Rebate Management

On August 1, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the application process for the 340B Rebate Model Pilot Program, a move that may redefine how providers access cost relief under the 340B program. Instead of traditional point-of-sale discounts, this pilot will allow for rebates after purchase for covered outpatient drugs reimbursed under Medicaid.

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Rebate Audits Are On the Rise—Is Your Program Ready?

As healthcare organizations look to rebate programs to offset tightening margins, audit readiness is becoming a strategic necessity.

Increased scrutiny from manufacturers and evolving requirements around documentation, PHI use, and clinical coding are shifting rebate submissions from “nice-to-have” to regulated deliverables.

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