Certification of Pharmacy Technicians (ExCPT) Practice Exam

What are companies that administer drug benefit programs commonly called?

1. HMOs

2. PBMs

3. MACs

4. PPOs

The correct answer is: PBMs

Companies that administer drug benefit programs are commonly referred to as Pharmacy Benefit Managers (PBMs). PBMs play a crucial role in the healthcare system by managing prescription drug benefits on behalf of health insurers, employers, and government programs. They negotiate prices with drug manufacturers and pharmacies, create formularies, and determine the reimbursement rates for medications, thereby influencing the overall cost and accessibility of prescription drugs for patients. PBMs also work to ensure the appropriate use of medications, managing aspects such as prior authorizations and quantity limits, which helps oversee the quality of care. Their involvement ultimately aims to optimize medication management for patients while controlling costs for payers. Understanding the role of PBMs is essential for pharmacy technicians, as they often interact with these organizations during the dispensing of medications and the processing of insurance claims.