When the $10K brand name drug is more affordable than its $450 generic: How PBMs control the system
Pharmacy benefit managers — the much-maligned middlemen between drug manufacturers and health insurers — often tilt the market, 80% of which is controlled by 3 of the largest PBMs, in their own and unusual ways.
These games, like clawing back money after a prescription has been dispensed, or offering reimbursements that don’t cover the cost of what pharmacies pay for a drug, were on full display at Thursday’s meeting where the Federal Trade Commission debated whether to look into these PBMs, some of which have grown so big to be on the Fortune 15.
Unlock this article instantly by becoming a free subscriber.
You’ll get access to free articles each month, plus you can customize what newsletters get delivered to your inbox each week, including breaking news.