Over the last decade, the number of pharmaceutical benefits managers h
as increased, and their influence has expanded rapidly. These managers
now provide prescription drug coverage to more than 100 million Ameri
cans. The effect of pharmaceutical benefits managers on health care de
livery remains unclear. We review the development of these organizatio
ns, their current role in the delivery of pharmaceutical therapies to
patients, and their relationship with pharmaceutical manufacturers. We
discuss potential advantages and disadvantages of pharmaceutical bene
fits manager practices and suggest ways in which these organizations c
an be made more accountable to the employer groups that hire them.