Pharmaceutical benefit management (PBM) is an exercise in balancing unlikely bedfellows:

quality improvement
cost-containment and
the ethical treatment of patients

Aren't these the very same issues that will make or break managed care as we know it?

Burton, Randel, and Titlow have listed six values to consider in this context (in their order):
(1) Accepting resource constraints
(2) Helping the sick
(3) Protecting those who cannot afford care
(4) Respecting physicians' autonomy
(5) Encouraging trust in the patient-physician relationship
(6) Promoting inclusive decision making.

Burton S, Randel L, Titlow K, et al: The ethics of pharmaceutical benefit management. Health Affairs 2001;20(5):150-163.