Title: Pharmacy and PBMs for Employers Source: https://ethosbenefits.com/topics/pharmacy Publisher: Ethos Benefits Summary: How pharmacy benefit managers are paid and how to read their contracts: spread pricing, rebates, formularies, specialty drugs and PBM reform. 1. [Home](https://ethosbenefits.com/) 2. [Learn](https://ethosbenefits.com/learn) 3. Pharmacy and PBMs # Pharmacy and PBMs. Where drug dollars go. How pharmacy benefit managers are paid and how to read their contracts: spread pricing, rebates, formularies, specialty drugs and PBM reform. Start with the main guide ## [How to choose a PBM](https://ethosbenefits.com/benefits-101/how-to-choose-a-pbm) To choose a good PBM, an employer should compare contracts, not just price quotes. Check how brand, generic and specialty drugs are defined, what share of rebates reaches your plan, whether spread pricing is allowed, and your audit, data and termination rights. A standardized, scored RFP makes the bids comparable. [Read the guide](https://ethosbenefits.com/benefits-101/how-to-choose-a-pbm) In this guide 1. What does a PBM do for your plan? 2. Why does the contract matter more than the quote? 3. The contract terms to check first 4. What questions should you ask every PBM? 5. What are the red flags in a PBM bid? 6. How does a PBM RFP work at Ethos Benefits? 7. What does federal law now require of PBMs? ## Guides 3 - [**Medical vs. pharmacy benefits** Pharmacy and PBMs _Guide_](https://ethosbenefits.com/benefits-101/medical-vs-pharmacy-benefits) - [**PBM spread pricing** Pharmacy and PBMs _Guide_](https://ethosbenefits.com/benefits-101/pbm-spread-pricing) - [**Pharmacy benefits administrator** Pharmacy and PBMs _Guide_](https://ethosbenefits.com/benefits-101/pharmacy-benefits-administrator) ## Insights 4 - [Sep 29 2026 **GLP-1 coverage decisions for 2027** Pharmacy and PBMs _Insight_](https://ethosbenefits.com/insights/glp-1-coverage) - [Aug 20 2025 **PBM reform is now law** Pharmacy and PBMs _Insight_](https://ethosbenefits.com/insights/pbm-reform) - [Mar 12 2024 **The downside of vertical integration in healthcare** Pharmacy and PBMs _Insight_](https://ethosbenefits.com/insights/vertical-integration-in-healthcare) - [Dec 28 2023 **Mark Cuban's call** Pharmacy and PBMs _Insight_](https://ethosbenefits.com/insights/mark-cuban-wake-up-call-for-employers) [How Ethos Benefits helps **Pharmacy and PBM**](https://ethosbenefits.com/services/pharmacy-pbm) [See it in practice **Case study: Kalos Services**](https://ethosbenefits.com/results/kalos-services) Other topics [ERISA and plan documents](https://ethosbenefits.com/topics/erisa) [ACA reporting](https://ethosbenefits.com/topics/aca-reporting) [Compliance rules and deadlines](https://ethosbenefits.com/topics/compliance) [Plan financing](https://ethosbenefits.com/topics/plan-financing) [Stop-loss insurance](https://ethosbenefits.com/topics/stop-loss) [Fiduciary duty and advisor pay](https://ethosbenefits.com/topics/fiduciary-duty) [Benefits strategy and administration](https://ethosbenefits.com/topics/benefits-strategy) [A to Z glossary](https://ethosbenefits.com/benefits-101/glossary) ## See what your plan is really costing you. A Strategic Analysis starts with your plan documents and your broker agreement, then shows you what your plan costs, where the risk sits, and what a committee would decide with the full picture. [Request a Strategic Analysis](https://ethosbenefits.com/strategic-analysis) [Call (407) 803-4710](tel:+14078034710)