Which service is not typically offered by pharmacy benefit managers?

Which service is not typically offered by pharmacy benefit managers?

• A. Mail-Order Pharmacy
• B. Drug Utilization Review
• C. Formulary Management
• D. Insurance Underwriting

Answer: (D)

PBMs manage prescription drug benefits for health plans, focusing on controlling costs and ensuring appropriate medication use. They typically offer mail-order pharmacy services to improve convenience and reduce costs, perform drug utilization reviews to promote safe and effective use, and handle formulary management to decide which drugs are preferred and to negotiate rebates with manufacturers. Insurance underwriting, on the other hand, involves assessing risk and setting premiums for insurance policies—functions handled by insurers or underwriters, not by PBMs. So underwriting isn’t a standard PBM service, making it the correct choice.

PBMs manage prescription drug benefits for health plans, focusing on controlling costs and ensuring appropriate medication use. They typically offer mail-order pharmacy services to improve convenience and reduce costs, perform drug utilization reviews to promote safe and effective use, and handle formulary management to decide which drugs are preferred and to negotiate rebates with manufacturers. Insurance underwriting, on the other hand, involves assessing risk and setting premiums for insurance policies—functions handled by insurers or underwriters, not by PBMs. So underwriting isn’t a standard PBM service, making it the correct choice.