What is the primary purpose of a pharmacy benefit manager (PBM)?

The primary purpose of a pharmacy benefit manager (PBM) is to manage the cost and utilization of medications. PBMs serve as intermediaries between insurers, pharmacies, and patients. They negotiate drug prices and establish formularies—lists of covered medications—to ensure that medications are provided at the lowest possible cost while maintaining a balance between accessibility and quality of care.

This function is critical in promoting cost-effective use of pharmaceuticals, ensuring that patients receive necessary medications without excessive out-of-pocket expenses. By focusing on managing costs and utilization, PBMs play a vital role in controlling healthcare expenditures and can influence medication adherence by making medications more affordable.

The other choices do not accurately reflect the primary responsibility of a PBM. Promoting brand-name drugs could be part of their function if it is financially beneficial; however, it is not their main goal. Diagnosing patient conditions and providing direct patient care are responsibilities typically handled by healthcare providers, such as physicians and pharmacists, and are not within the scope of a PBM's role. Hence, the emphasis is rightly placed on their function in cost and utilization management.