Managed Healthcare Executive’s Susan Sadika quotes Joseph Paduda in this article on how niche PBMs survive in a world of mega PBMs better buying power. “They have to compete on the basis of something else, such as focusing on certain diseases or niche businesses, such as workers’ compensation,” Paduda says.

The piece points out that size gives larger PBMs better buying power and Paduda acknowledges that makes it tough to compete. Large PBMs can negotiate rebates (which are controversial) and discounts from drug manufactures. While not exclusive to workers’ comp, the article gives WC payers insight into the pharma world and is worth the read.