Several reforms have been proposed to regulate PBMs.

目前已经提出了几项管理这个机构的改革。

Rebates on prescription drugs are generally paid by a pharmaceutical manufacturer to a PBM.

处方药的回扣通常由制药商支付给药品福利管理机构。

PBMs manage prescription drug benefits on behalf of health insurers, drug plans, large employers, and other payers.

药品福利管理机构代表健康保险公司、药品计划、大型雇主和其他支付者管理处方药福利。

At the same time, most private insurance companies outsource negotiating medicine costs to pharmacy benefit managers, also known as “PBMs.”

与此同时，大多数私营保险公司将药品成本谈判外包给药房利益管理人员，也称为“药品福利管理人员”。

This was mostly because of a 31% jump in disbursements on speciality medicines, according to a report from Express Scripts, another PBM.

根据来自快捷药方公司（另一家医药福利管理公司）的报告显示，这主要是由于专业药品的支出增长了31%。

But the problem is this: since these rebates are calculated as a percentage of a manufacturer's list price, the PBMs have an incentive to favor purchasing higher-priced drugs.

由于这些回扣是按生产商标价的百分比计算的，药品福利管理机构就会倾向于购买价格较高的药品。