SmithRx: Radically Transparent Pharmacy Benefits
PBM Frequently Asked Questions
At SmithRx we believe a modern pharmacy benefit manager’s role is to maximize your pharmacy savings and member experience. Unlike complex, opaque legacy players, everything we do is built upon a foundation of alignment, transparency, execution, consistency, and simplicity. This FAQ page is designed to answer the most common questions we receive about Pharmacy Benefit Managers (PBMs), our unique approach, and how members can best navigate their prescription benefits.
Understanding Pharmacy Benefit Managers (PBMs)
What is a Pharmacy Benefit Manager (PBM)?
What does a PBM do?
What is a legacy PBM?
What is a modern PBM?
Are PBMs owned by insurance companies?
How do PBMs make money?
What is the relationship between PBMs and pharmaceutical manufacturer companies?
Drug Coverage and Costs
What is a formulary (also known as: prescription drug list)?
What is a non-formulary drug?
What's the difference between spread pricing and pass-through pricing?
What is a maximum allowable cost (MAC) list?
What is a biosimilar?
What is a drug rebate?
How does a drug rebate work?
What is the difference between brand name and generic medications?
How do I know if my insurance covers a certain medication?
Mail Order and Specialty Medications
What are the benefits of mail-order pharmacies?
What is a specialty medication?
SmithRx Services and Approach
How does SmithRx work with independent pharmacies?
Who is SmithRx?
How does SmithRx support medication adherence and patient outcomes?
How does SmithRx partner with Amazon Pharmacy?
How does SmithRx partner with Mark Cuban Cost Plus Drugs?
What pharmacies are available to SmithRx members?
Helpful Resources
SmithRx is on a mission to reduce the complexity and costs of pharmacy benefits with radical transparency and cutting-edge technology.