Yes, it is another middleman between patients and their care. However, they are also much like those automatic Code searchers on a Google account when you check out that makes sure patients are receiving as big of a discount as possible from the drug manufacturer, which can be pretty substantial. And because the insurance company gets a fraction of the drug rebates many self-funded employers get free admin services by signing up for a PBM with an insurance company. So on the whole the employer groups largely end up with a better deal because they get free admin services and huge savings on pharmacy.