Pharmacy Benefit Managers: Contracting Landscape and Manufacturer Competitive Assessment

Partnerships with pharmacy benefit managers (PBMs) are critical to maintaining favorable pharmaceutical product market access. HIRC's report, Pharmacy Benefit Managers: Contracting Landscape and Manufacturer Competitive Assessment, reviews pharmacy benefit manager executives' evaluation of manufacturers and focuses on trends in contracting. The report addresses the following questions:

• Who do PBMs select as their overall manufacturer partner of choice?
• How do 40+ pharmaceutical manufacturers rate in willingness to contract?
• Which manufacturers are nominated as most willing to contract for medications covered under the pharmacy benefit? On the medical benefit?

Key Finding: The largest PBMs have a GPO contracting entity involved in manufacturer contract negotiations; GPO's most commonly charge manufacturers administrative fees and vendor fees (data & contracting charges).

PBMs Report that Contracts are Most Common for GLP-1, RA, and MS Medications. Pharmacy benefit manager key decision-makers were asked to consider a list of 20+ therapeutic areas and indicate the status of contract offerings in the past 12-18 months. Panelists most frequently report contracts for obesity/diabetes - GLP-1 agonists, rheumatoid arthritis, and multiple sclerosis medications (69% of respondents), followed by airway diseases (66%), diabetes - SGLT2 inhibitors (63%), and migraine products (63%).

The complete report provides the types of contracts reported and most common discount/rebate amounts across 22 therapeutic areas.

Research Methodology and Report Availability. In December 2024 and January 2025, HIRC surveyed 32 pharmacy benefit manager key decision-makers from very large, mid-size, and small/upcoming PBMs. Online surveys and follow-up telephone interviews were used to gather information. The complete report, Pharmacy Benefit Managers: Contracting Landscape and Manufacturer Competitive Assessment, is available now to HIRC’s Managed Markets subscribers at www.hirc.com.