Opinion: The emergence of laboratory benefits managers: PBM déjà vu?
Pharmacy benefits managers (PBMs), the companies that administer prescription drug coverage for employers, municipalities, insurance companies, and the like, have taken heat for adding to the cost of drugs instead of controlling or lowering them. Sen. Ron Wyden (D-Ore.) has called PBMs “gnarled, confounding riddles.” An emerging parallel industry, laboratory benefits managers (LBMs), could be following in their footsteps.
Although the exact scope of work varies from contract to contract, the tendrils of laboratory benefits managers can extend from routine lab tests, such as cholesterol or HbA1c, to genetic tests, such as proprietary diagnostic tests for cancer, and even to digital diagnostics such as home blood pressure monitoring. In some cases, they may also manage MRIs or other forms of imaging and screening procedures like mammograms and colonoscopies.
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