The growth in prescription drug spending, especially with the emergence and importance of specialty pharmaceuticals, will bring increasing emphasis on managing the prescription drug benefit. Employers should become informed consumers, understanding how revenue is generated by pharmacies as well as by intermediaries such as PBMs. Organizations like health systems and academic institutions who have internal expertise or internal pharmacies may be able to take advantage of opportunities to assume more management responsibility for the prescription drug benefit, working in a collaborative and more transparent manner with other stakeholders. Those employers without internal expertise may still benefit through a greater understanding of the pharmaceutical supply chain and consulting assistance in negotiating mutually beneficial arrangements with PBMs and other stakeholders.

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