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Workers' comp reimbursements lead to big paydays for PBMs

In the shadowy world of pharmacy benefits management, exploiting workers compensation reimbursement rates is one of the many ways PBMs ensure their own massive profits while ultimately driving up drug costs for employers and consumers.

By Dave Marley | Updated on July 30, 2012

If you ascribe to the generally accepted principles that most employees don’t wish to become sick or injured and miss work, and most employers don’t wish to use valuable resources providing workers compensate packages, it’s hard to imagine why workers’ compensation would be seen as anything other than a necessary workplace safeguard.

But talk about workers’ compensation with pharmacy benefit managers (PBMs), the third party administrators of prescription drug programs, and their eyes instantly light up. That’s because for PBMs, workers’ compensation provides a great opportunity for increased profits without increased work.

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