Does Your PBM Sell Drugs, or Manage Drug Costs?

Pharmacy benefit managers (PBMs) were created to help employers manage prescription drug costs—by negotiating prices, processing claims, and improving medication access for members.

  • 2 Min read

  • March 20, 2025

Susan Thomas

Susan Thomas

CCO, LucyRx
Educational Resources
drugs

Pharmacy benefit managers (PBMs) were created to help employers manage prescription drug costs—by negotiating prices, processing claims, and improving medication access for members.

But somewhere along the way, that mission got lost.

Today, many traditional PBMs do more than manage benefits—they also own pharmacies, control formularies, and profit from the very drug pricing they claim to manage. When one organization plays both sides, can it really act in your best interest?

It’s the classic “fox guarding the henhouse.” And employers are left footing the bill.

What That Looks Like in Practice

When PBMs profit from drug markups or rebate incentives, employers may face:

  • Inflated pricing disguised by rebate guarantees
  • Limited visibility into where dollars are going—and why
  • Disrupted care pathways as members are pushed toward preferred pharmacies
  • Markups of up to 1,000% on generics and specialty medications

“These are the devastating realities of our healthcare system: patients skipping essential medications or draining their savings just to afford care,” says Susan Thomas, Chief Commercial Officer at LucyRx. “Employers, patients, and independent pharmacies all bear the burden of these outdated practices.”

A Different Model—Built on Clarity and Care

At LucyRx, we believe pharmacy benefits should serve employers and members—not middlemen.

That’s why we built a different kind of PBM. One that:

  • Doesn’t own pharmacies or profit from inflated pricing
  • Doesn’t steer volume based on rebates
  • Does align 100% with your goals through a fiduciary model
  • Does build custom benefit plans tailored to your population’s needs

With LucyIQ, our AI-powered analytics platform, we give employers the insight they need to manage spend, reduce waste, and improve outcomes—with no hidden incentives.

pharmacist

Take Back Control of Your Pharmacy Benefits

If your PBM is both selling drugs and setting the prices, you have to ask: who are they really working for?

LucyRx puts employers back in control—with a smarter, clearer, and more human-centered approach to prescription care.

Download our eBook: 9 Things Your PBM Doesn’t Want You to Know.

You’ll find proven strategies to reduce drug costs, expose hidden fees, and bring accountability to your PBM relationship—without compromising care.

Get the eBook

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LucyRx is a fast-scaling, independent, next-generation pharmacy benefit manager (PBM) redefining prescription care for plan sponsors and members nationwide.

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