The Differences Between the Big 3, Non-Traditional PBMs

With new and emerging pharmacy benefit managers (PBM) in the prescription drug supply chain, competition within the market has been unprecedented as of late. Highlighting the key differences between the ways in which large and small PBMs operate within the market, experts believe emerging PBMs have the potential to enforce indefinite change in the way prescription drug benefits are administered in the US.

“[The Big 3 PBMs] are involved in government programs; the little guys usually don't get shots at that,” Bil Schmidtknecht, founder of Patient Protector and director of patient experience at AffirmedRx, told Drug Topics. “They're publicly traded companies; that's the big thing. The transparent one that I work with, it's a public benefit corporation. We don't worry about the profit; that's not our goal. The big guys, they have a fiduciary responsibility.”

In part 2 of our interview with Schmidtknecht, he discusses the differences between the Big 3 PBMs—Optum Rx, CVS Caremark, and Express Scripts—and smaller, less financially powerful groups that manage prescription drug benefits. He also discussed how these lesser-known but transparency-focused PBMs have the ability to enact more competition, and more importantly, change in the way patients receive their medications.

Since experiencing the tragic events of his son Cole, Schmidtknecht has dedicated his life to patient advocacy and is now working with transparent PBM AffirmedRx. Learn more about his recent ventures with alternative PBMs as well as his fight to reform companies like Optum, CVS, and Express Scripts.

To learn more about Schmidtknecht’s story and the events that led him to the PBM reform and patient advocacy spaces, check out part 1 of our interview, where he shared his son’s tragic story and highlighted the increasingly looming need for change in the distribution of prescription drugs and their benefits.

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