--- title: "How PBMs Make Money: PBM Practices & Profits - [Infographic]" description: How do PBMs make money? We examine the problems and pitfalls with pharmacy benefits manager practices in the US healthcare system through this infographic. image: https://info.rxsafe.com/hubfs/PBM_infographic_feat.png --- - [Facebook](https://www.facebook.com/RxSafe) - [Twitter](https://twitter.com/RxSafe) - [LinkedIn](https://www.linkedin.com/company-beta/2896335/) - [YouTube](https://www.youtube.com/user/RxSafe) - [RSS](https://rxsafe.com/feed) [![black-order\_cart\_2a@1.5x](https://info.rxsafe.com/hubfs/black-order_cart_2a@1.5x.png "black-order_cart_2a@1.5x")](https://reorder.rxsafe.com) [(877)-797-2332](tel:1-877-797-2332) [![eyecon-RxSafe-combo-logo-blk-200x56](https://info.rxsafe.com/hs-fs/hubfs/eyecon-RxSafe-combo-logo-blk-200x56.png?width=200&height=56&name=eyecon-RxSafe-combo-logo-blk-200x56.png)](https://rxsafe.com/) - [SOLUTIONS](https://rxsafe.com/solutions-2/) - Pouch Packaging - [RapidPakRx](https://rxsafe.com/solutions/rapidpakrx/) - [Vial Filling-Secure Med Storage](https://rxsafe.com/solutions/vial-filling/) - [RxSafe 1800 w/RWS](https://rxsafe.com/solutions/rxsafe-1800-w-rws-copy/) - [Blister Card Filling](https://rxsafe.com/solutions/blister-card-filling/) - [RapidCardRx](https://rxsafe.com/solutions/rapidcardrx/) - [RapidCardSD](https://rxsafe.com/solutions/rapidcardsd/) - Pill Counting - [Eyecon](https://www.eyeconvpc.com/) - IMPACT - [Success Stories](https://rxsafe.com/case-studies/) - [Before & After](https://rxsafe.com/services/installation/) - [FAQS](https://rxsafe.com/faqs/) - [Blog](https://info.rxsafe.com/blog/) - [Videos](https://rxsafe.com/resources/videos/) - [ABOUT](https://rxsafe.com/about/) - [Events](https://rxsafe.com/events/) - [Careers](https://rxsafe.com/about/careers/) - [Testimonials](https://rxsafe.com/about/testimonials/) - [CONTACT US](https://rxsafe.com/contact/) - [Training and Support](https://rxsafe.com/services/training-and-support/) # How PBMs Make Money: PBM Practices & Profits - \[Infographic\] [mail-order pharmacies](https://info.rxsafe.com/blog/tag/mail-order-pharmacies), [PBMs](https://info.rxsafe.com/blog/tag/pbms), [pharmacy benefit managers](https://info.rxsafe.com/blog/tag/pharmacy-benefit-managers), [DIR fees](https://info.rxsafe.com/blog/tag/dir-fees), [infographic](https://info.rxsafe.com/blog/tag/infographic) Growing awareness about the problems and pitfalls with [pharmacy benefits managers](https://ncpa.org/pbm-resources) (PBMs) in the US healthcare system has taken hold in recent years. Originally contracted by insurance carriers to negotiate on their behalf with pharmaceutical companies, these "middlemen" have hijacked the prescription drug marketplace to the detriment of pharmacies and patients. ## How Do PBMs Make Money? PBMs generate some $315 billion annually from five[income streams](https://www.pssny.org/page/PBMBasics) that include rebate sharing, pharmacy spread, PBM-owned pharmacies, administrative fees, and DIR fees. ### Rebate Sharing Insurance companies pay PBMs to manage drug costs and receive rebates from manufacturers. PBMs will often retain a portion of the rebate. PBMs will also negotiate prices with manufacturers, who then pay rebates to the PBM for preferred placement on a plan's[formulary](https://www.goodrx.com/insurance/medication-formulary). #### Pharmacy Spread Health plans are billed for amounts higher than they reimburse pharmacies (upcharging), creating a "pharmacy spread." #### PBM-Owned Pharmacies PBMs own retail and mail order pharmacies, such as CVS. They make money when patients are forced to use mail order and purchase exclusively from them. #### Administrative Fees Administrative fees are fees charged by PBMs for the electronic processing of each claim. These fees can range anywhere from $1.25 to $3.50 per script, plus the transaction fee of $0.10 5o $0.15 per claim. #### DIR Fees "[Direct and indirect remuneration](https://info.rxsafe.com/blog/1830-for-a-gallon-of-gas)" fees are imposed on pharmacies after a patient sale that is not readily predictable. These fees may include "pay-to-play" fees for network participation, periodic reimburse-reconciliations, or non-compliance with quality measures.  ### Pharmacy Benefit Managers: Practices & Profits Infographic This infographic (click below to zoom in) exposes a few "trade secrets" the PBMs don't want you to know about, as well as their control of the market, hundreds of billions in profits extracted from the industry, how states are pursuing legislation to curtail anti-competitive PBM practices, and what you can do to support these efforts. ![PBM practices and profit sources explained](https://info.rxsafe.com/hs-fs/hubfs/PBM_infographic_V2.png?width=792&name=PBM_infographic_V2.png) Join us for a [free webinar](https://register.gotowebinar.com/register/956686575118104333) on September 29th at 8PM EDT/5PM PDT where we discuss the case on pharmacy benefits managers regulations. To learn more about how you can fight back, [click here](https://ncpa.org/rutledge-v-pcma-webinar). ## RxSafe ![](https://info.rxsafe.com/hubfs/eyecon_rxsafe_favicon%20(1).svg) RxSafe improves patient health by partnering with the nation’s 21,000 independent retail pharmacies, using our technology solutions to transform the way you do business. We collaborate with pharmacies and other industry innovators to enable patient adherence, attract new customers, create additional revenue streams, and boost profitability. Learn more: www.rxsafe.com. #### Related Posts ## [DIR Defense Tactics from NCPA](https://info.rxsafe.com/blog/dir-defense-tactics-from-ncpa) December 19, 2023 [![](https://info.rxsafe.com/hubfs/NCPA%20panel%20group%20shot.jpg)](https://info.rxsafe.com/blog/dir-defense-tactics-from-ncpa) ## [NCPA 2023 Preview](https://info.rxsafe.com/blog/ncpa-2023-preview) October 11, 2023 [![](https://info.rxsafe.com/hubfs/NCPA%202023.jpg)](https://info.rxsafe.com/blog/ncpa-2023-preview) ## [PBMs, Drugmakers Spar on Insulin Price Gouging](https://info.rxsafe.com/blog/pbms-drugmakers-spar-on-insulin-price-gouging) June 2, 2023 [![](https://info.rxsafe.com/hubfs/Insulin%20prices.jpg)](https://info.rxsafe.com/blog/pbms-drugmakers-spar-on-insulin-price-gouging) [![demo graphic ](https://info.rxsafe.com/hs-fs/hubfs/demo%20graphic%20.png?width=314&height=220&name=demo%20graphic%20.png)](https://rxsafe.com/contact/) [![Eyecon 250x175 1](https://info.rxsafe.com/hs-fs/hubfs/Eyecon%20250x175%201.png?width=323&height=226&name=Eyecon%20250x175%201.png)](https://www.eyeconvpc.com/contact-the-eyecon-sales-team/) ### Most recent posts [Celebrating Dave Lang: 48 Years, One Remarkable Career](https://info.rxsafe.com/blog/celebrating-dave-lang) [![](https://info.rxsafe.com/hubfs/Dave%20Lang-1.png)](https://info.rxsafe.com/blog/celebrating-dave-lang) [Maximize Pharmacy Investment with Section 179 in 2026](https://info.rxsafe.com/blog/section-179-and-your-pharmacy) [![](https://info.rxsafe.com/hubfs/2026%20Section%20179%20(35%20x%2015%20in)%20(1).png)](https://info.rxsafe.com/blog/section-179-and-your-pharmacy) [Customer Spotlight: Debbie's Family Pharmacy — From Falling Behind to Two Weeks Ahead](https://info.rxsafe.com/blog/customer-spotlight-debbies-family-pharmacy) [![](https://info.rxsafe.com/hubfs/CustomerSpotlightDebbies-1.png)](https://info.rxsafe.com/blog/customer-spotlight-debbies-family-pharmacy) #### CONTACT US [2453 Cades Way, Ste. 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