In 2023, 15 pharmacy benefit managers (PBMs) reported receiving payments from pharmaceutical drug manufacturers, which included rebates, fees, and price protection payments.
The reduction in three payment categories is due to the largest PBM reporting a reduced number of clients this year compared to last year:
- $2.68 billion less passed to issuers.
- $390 million less retained as revenue.
- $3.07 million less collected from manufacturers.
A different PBM reported $14.6 million more passed to enrollees compared to last year.
TDI gathers this information under Texas Insurance Code Sections 1369.502 and 1369.503. TDI only reports the data the PBMs supply and doesn't audit it.
Payments from pharmaceutical drug manufacturers
| Amount passed to issuers | $2.07 billion |
| Amount passed to enrollees | $15 million |
| Amount retained as revenue | $91 million |
| Total amount | $2.12 billion |
Note: The “Total amount collected from pharmaceutical drug manufacturers” is lower than expected. Three of the 15 PBMs reported amounts lower than the total of the first three amounts for this question.