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Pharmacy Benefit Managers Handle Almost 80 Percent of U.S. Prescriptions.

By Maria M. Perotin, Fort Worth Star-Telegram, Texas Knight Ridder/Tribune Business News

Sep. 4--For many insured Americans, it's a common scenario: Your doctor suggests medicine to treat an ongoing illness, but several different drugs can do the job. Your health insurer says you can buy one drug for a $40 co-payment or spend $25 for a preferred alternative. Or you can save more by sending your prescription to a mail-order pharmacy.

The choices for consumers may seem simple. But the behind-the-scenes maneuverings that led to these choices are anything

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