The PBM Model of the Future: Why Payers Are Unbundling PBM Services


Blue Shield of California has chosen an unbundled approach to pharmacy benefits management, which is a departure from standard practices. This model, referred to as virtual PBM, allows payers to select best-in-class partners to manage individual or multiple pharmacy benefit management functions. It is seen as an attractive alternative to the traditional model, offering benefits such as increased visibility, cost clarity, and flexibility. The industry is making a shift towards unbundled PBM services, driven by competitive concerns, regulations, and a move towards consumerism in healthcare. Plans with greater resources are well-suited for virtual PBMs. Additionally, new entrants to the PBM market are expected to bring innovation, competition, and improve service.

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