What is the primary goal of utilizing pass-through pricing in pharmacy benefits management?

The primary goal of utilizing pass-through pricing in pharmacy benefits management is to improve cost transparency. This pricing model allows for the direct passing of drug costs and rebates from the pharmaceutical manufacturers to the plan sponsors without the pharmacy benefit manager (PBM) taking a significant spread or markup for themselves. By doing so, it provides clearer visibility into actual costs, as plan sponsors can see exactly what they are paying for medications, including any discounts or rebates applied. This transparency helps plan sponsors make more informed decisions regarding their pharmacy benefit programs, as they have a clearer understanding of the costs associated with medications and how pricing structures are formulated.

This model promotes a more straightforward relationship between PBMs, plan sponsors, and pharmacies, ensuring that the funds are allocated appropriately and that there is less ambiguity around pricing practices. Hence, improving cost transparency is an essential aspect of pass-through pricing, benefiting both the plan sponsors and ultimately the patients receiving medications.