If prices rise more than an agreed upon rate, excess increases may be offset by additional rebates. For some employers this means the PBM is pocketing some or all of the rebate money, driving record profits. In these cases there is absolutely no incentive on the part of the PBM to lower Rx costs. Rather, they earn more kickbacks as drug costs escalate. This revenue sharing between the PBMs and manufacturers at the expense of consumers continues to fuel spiraling Rx costs.