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The Nephron analysis also found that commercial rebates, along with pricing protection fees (where a manufacturer pays a PBM a fee if the list price increases above an agreed-upon amount over an agreed-upon timeframe) and spread pricing (where a PBM charges the insurance provider or a patient paying outside of insurance more for a drug than it paid the pharmacy for that drug) make up between 20 percent and 24 percent of PBM profits, while mail-order pharmacy revenue makes up another 16 percent

Am J Manag Care (2011) 17(2 Suppl):s5970

They may be able to help by changing the time of day you take your medication or even prescribing a different one

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