Healthcare costs
This article examines Pharmacy Benefit Managers (PBMs), the primary culprit responsible for your financial pain. The discussion addresses essential questions about how the Pharmacy Benefit Management system directly impacts you, the consumer.

PBM, 4 astonishing reasons for our costly prescription drugs.

Table of Contents

Bennie Gates JD

Bennie Gates JD

Dedicated to fighting against the outrageous cost of healthcare.

This article examines Pharmacy Benefit Managers (PBMs), the primary culprit responsible for your financial pain. The discussion addresses essential questions about how the Pharmacy Benefit Management system directly impacts you, the consumer.

Introduction

A broken healthcare system and the prescription drug delivery network exist in America. This unregulated and secretive enterprise must bend to the will of the people.

The inability to pay for prescription drugs is a problem for millions of Americans. Significant factors contributing to this dilemma include increased premiums deductibles, copays, prior authorizations, and reduced access to life-sustaining medications.

This article examines Pharmacy Benefit Managers (PBMs), the primary culprit responsible for your financial pain. The discussion addresses essential questions about how the Pharmacy Benefit Management system directly impacts you, the consumer.

Congress and our state legislatures are ineffective because of the financial power of the drug lobby influence. But the solution to the problem is something that you can control. You will discover how to drive costs down by being an informed consumer.

The prescription drug industry cannot deny the power of the public to right the wrongs of the unscrupulous. Former Supreme Court Associate Justice Louis Brandeis was correct when he stated, “If the broad light could be let in upon men’s actions, it would purify them as the sun disinfects.”

The goal of this paper is to inform and invite you to act. PBMs neither make nor sell prescription medications. However, they control about 280 million consumers’ access to the system. This control is unregulated by any level of government. Influencing access is done in complete secrecy.

You can change the system through your initiative. It would be best to demand transparency in prescription medications’ production, pricing, and marketing. Transparency promotes competition. Competition leads to lower prices because of public disclosure of accurate and actionable information.

Enjoy the article! You have more power than you think.

Pharmacy Delivery Network and YOU
PBM, 4 astonishing reasons for our costly prescription drugs. 1

Prologue

The U.S. spends more than other countries on prescription drugs. For example, in 2020, for 20 selected brand-name prescription drugs, estimated U.S. prices paid at the retail level by consumers and other payers, such as insurers, were more than two to four times higher than prices in Australia, Canada France. Additionally, consumers’ out-of-pocket costs for prescription drugs varied across and within all four countries but more within the U.S. and Canada, where multiple payers had a role in setting prices and designing cost-sharing for consumers. Not all consumers had prescription drug coverage. (Prescription Drug Spending | U.S. GAO, n.d.)

What factors influence drug prices?

Control of drug prices occurs through an overall lack of price transparency in the healthcare industry. Consumers can exercise the same good judgment to shop for drugs for other commodities. 

However, among other factors, the lack of competition has increased prices for certain generic drugs.

On the other hand, generic drugs compete with the brand-name or different generic versions of the same drug primarily through price—and the costs of generic medications fall as additional manufacturers enter the market.

What does a PBM do?

Pharmacy Benefit Managers administer prescription drug benefits in America. Clients include private health insurers, Medicare, Medicaid, and the Veteran’s Administration.

PBMs negotiate prices with drug manufacturers, pharmacies, and drug wholesalers. The PBM management system controls consumer accessibility to prescription drugs.

How do PBMs control how much consumers spend on prescription drugs?

Approximately 280 million Americans have a PBM, and most have no idea how much these companies influence their access to prescription medications. A PBM is an organization that helps manage prescription drug benefits on behalf of individuals or employers (e.g., health plans).

Why do PBMs establish a formulary?

PBMs create a formulary for a health plan, which tells the insurance company what drugs they will cover and at what cost. PBMs “negotiate” with drug manufacturers for prices.

How do PBMs design tiered formularies?

PBMs design tiered formularies and decide how much an individual will pay for their prescription. Placing prescription drugs in tiers is an essential strategy for PBMs to save money.

The prescription drug tier system is complicated—the industry structures drug tiers based on costs.

Who are a few of the major PBMs?

Below are the five top insurers and their pharmacy benefit management partners. These businesses deliver PBM benefits to about 80 percent of the PBM market.

  • UnitedHealth Group: OptumRx is the PBM for this organization.
  • Anthem: IngenioRx is the PBM for this organization.
  • Aetna: CVS Caremark is the PBM for this organization.
  • Cigna: Cigna Pharmacy Management is the PBM for this organization.
  • Humana: Humana Pharmacy Solutions is the PBM for this organization. (Fein, 2021)
PBM and Consultant market share
PBM, 4 astonishing reasons for our costly prescription drugs. 2

Why do insurers use PBMs?

Healthcare plans are supposed to use PBMs as a mechanism to secure lower costs for prescription drugs. But the Pharmacy Benefit Management system’s primary focus is on profitability. The industry uses secrecy and consumer confusion to conduct business in an unregulated environment.

Insurance companies use PBMs to adjust prices for people with high deductibles or no insurance coverage. Consumers are unable to determine the most cost-effective method of purchasing medications.

PBMs work on behalf of both the insurer and large employers. The PBM is only accountable to those who signed up with them, not to other people paying for their prescriptions.

Some doctors have complained that they do not get a fair share of the money saved. Pharmacy grumbles about being cut out of the loop are well known. (Top Insurers Move to Bring PBM Partners In-House | Ritter Insurance Marketing, n.d.)

What mergers have affected PBM Management?

Major mergers involving PBMs include CVS’ acquisition of Caremark in 2007 and Cigna’s purchase of Express Scripts last year. The alignment between insurance companies and PBMs is evident in the PBM industry.

Affiliation between PBMs, significant pharmacies, and insurance companies is expected. Mergers inhibit PBM transparency.

Who are some prominent PBM?

The top PBM in America are:

  • CVS Caremark. The location of CVS Caremark headquarters in Woonsocket, Rhode Island.
  • UnitedHealth Group’s OptumRx. UnitedHealth Group is in Minneapolis, Minnesota.
  • Express Scripts Holding Company. Express Scripts Holding Company is in St. Louis, Missouri

How do PBMs control how much consumers spend on prescription drugs?

PBMs negotiate prices with drug manufacturers and wholesalers in return for substantial rebates. There are many controversies about PBMs.

What is an example of the negative impact of PBMs on consumers?

Drug manufacturers raise prices to cover rebates. There is no consumer participation in the oversight of the system.

How do PBMs steer prescription drug demand?

PBMs exercise control over the demand for prescription drugs. PBMs steer business to a PBM pharmacist when feasible.

  • First, PBMs manage prescription drug benefits for customers. They do this by negotiating price discounts with drug manufacturers and pharmacies to ensure their members get the best prices on prescriptions. 
  • Next, PBMs are responsible for collecting co-pays from their members. 
  • Third, they manage member information to ensure efficient delivery of medications. 
  • PBMs funnel business to affiliated pharmacies. 
  • PBM companies will give customer information to their affiliated pharmacies but not share it with other ones.

PBMs are also in charge of processing prescription drug claims for the pharmacies.

How do PBMs use drug Tiers, Prior Authorization, and Step Therapy?

PBMs use Drug Tiers, Prior Authorization, and Step Therapy to control the prices of medications. PBMs use a Tier method for listing drugs in a Formulary. PBMs list drugs by therapeutic category.

The arrangement of the Tiers is by therapeutic category with preferred drugs listed on lower tiers. PBMs place less preferred drugs in the higher levels resulting in more significant consumer expense.

Additional methods PBMs use to control drug demand include the following:

  • “Step” or “Fail First” Therapy 
  • Prior Authorization (PA)

A PBMs’ job seems simple enough, but their practices are shrouded in mystery because of the lack of transparency about how these entities work.

Cost savings rarely reach consumers because PBMs have a significant role in negotiating with drug companies to set prices, and they also control the information provided to pharmacists.

What is another PBM practice detrimental to consumers?

“Spread pricing” is a questionable practice when PBMs pay a lower amount than they report to a health plan sponsor. The PBM pockets the difference. Spread pricing will be discussed in more detail later.

Pharmacy “gag clauses” were a widespread practice until new laws abolished the practice. PBMs prohibit pharmacies from disclosing cheaper alternatives when a consumer arrives to pay for prescriptions.

This practice occurred even though the cash price was less than the copayment!

What is behind the controversial PBM rebate system?

PBMs are controversial because they work for pharmaceutical companies, and they give physicians money to prescribe drugs that may not be as effective.

Rebates are controversial because they can encourage doctors to prescribe drugs that may not be as effective. PBMs use rebates because it’s a way for pharmaceutical companies to promote their drugs.

Doctors and physicians do not always receive the total rebate when they prescribe expensive medications because of low volume discounts. Pharmacies accept PBM rebates when they have a contract with the PBM.

A pharmaceutical company pays the pharmacy less for their drugs because of low volume discounts. (Seeley & Kasselheim, 2019)

Why don’t consumers benefit from PBM rebates?

Consumers do not benefit from PBM rebates because PBMs keep most rebates, collaborating with drug manufacturers that do not compete on price. (Hedt, 2020)

The healthcare system has changed in recent decades to one where people are required to pay for most health care services out of their own pockets. The responsibility for paying has shifted from third parties to the individual.

What are other PBM controversies?

Recently, many healthcare professionals and advocates have become concerned that the services offered by PBMs do not contribute enough positive value to merit the excessive costs and impact on the overall price of health care.

PBMs counter that they have passed along a larger share of the rebates to insurers. There is much debate over whether PBMs should keep drug manufacturers’ rebates, secret.

Some believe compelling PBMs should “pass through” all or a more sizable portion of these savings to health insurers and other payers.

If regulations require PBMs to do this, insurers could use the savings to reduce people’s premiums and cost-sharing payments further. (Seeley & Kasselheim, 2019)

What are the reasons Consumers do not benefit from PBM rebates?

Consumers do not benefit from the rebate system. Unsuspecting consumers fund the secretive system. The rebate practice is an industry “cash cow” in the Pharmacy Benefit Management system.

When will Consumers benefit from the PBM rebate system?

Consumers have not received lower costs from the PBM rebate system. In the past, PBMs could offer discounts to wholesalers as a rebate for purchasing from them exclusively.

There is no period for PBM Management to share rebates with consumers. The excessive profits are enjoyed by PBM shareholders. Consumers will have to drive prices lower by insisting on prescription drug transparency.

How do PBMs obtain clients?

Employers pay healthcare consulting firms to help them manage their healthcare coverage. Healthcare consulting firms help employers select PBMs, create a PBM management plan, and provide other consulting services.

What is the relationship between healthcare consulting firms and PBMs?

The relationship between healthcare consulting firms and PBMs is often a source of conflict. Healthcare consulting firms solicit bids from PBMs and compare their prices and pharmacy networks. They are presenting the results of the bidding competition to Employers for their consideration.

The consulting companies have contracts with Fortune 500 and other large companies. The coalitions include hundreds of companies that employ millions of workers. (Herman, 2018)

Employers, Consultants and PBMs
PBM, 4 astonishing reasons for our costly prescription drugs. 3

Who are prominent healthcare consulting firms?

Three leading healthcare consulting firms are the following:

·       AON CONSULTANTS Insurance brokerage and human resources are among Aon Consultants’ professional expertise. Axios reporting indicates employers pay between $20,000 to $300,000 to join in 2020.

·       MERCER CONSULTANTS Mercer is an affiliate of Marsh & McLennan. The firm provides advice on the risk management strategies for healthcare.

·       WILLIS TOWERS WATSON Willis Towers Watson from England is now one of the world’s most significant HR and actuarial consulting firms.(Herman, 2018);(Maverick & Munichiello, 2021)

What is the impact of PBM on healthcare?

PBM in healthcare is supposed to help with the containment of healthcare costs. A PBM (or Pharmacy Benefit Manager) is a company that negotiates prices and availability of prescription drugs for large employers, insurance companies, unions, and government agencies.

Which PBM acquired the most prominent healthcare insurer in the United States?

The PBM acquired the most significant healthcare benefits company in the United States, a merger that controlled more than 70% of people who receive health benefits from employers through private exchanges. The two companies involved are Cigna and Express Scripts.

What is Pharmacy Benefit Management in healthcare?

The Pharmacy Benefit Management system manages the process of providing prescription drug coverage to employers, insurance companies, and individuals. PBM services are available to insured individuals through their employer, Medicare, Medicaid, or other government programs.

Pharmacy benefit managers, or PBMs, are the gatekeeper for America’s prescription drug network. PBMs control medication distribution through pharmacies and manage insurance coverage and pricing.

Pharmacy benefit managers, or PBMs, are the gatekeeper for America’s prescription drug network. PBMs control medication distribution through pharmacies and manage insurance coverage and pricing.

What steps have the Federal and State government taken to regulate the PBM industry?

Pharmacy Benefit Management under review
PBM, 4 astonishing reasons for our costly prescription drugs. 4

Federal and State officials are considering options, including:

  • Legislation enforcing price transparency in healthcare
  • Gather more data on the rebate process 
  • Regulate the PBM industry the same way Attorneys, Doctors, Real Estate Brokers, and other professionals are.
  • Require transparency of pharmacy cost schedules to track generic drug costs.
  • Require PBMs to share rebates with patients. 
  • The federal government has proposed requiring PBMs contracted with Medicare Part D plans to pass through money received.
  • They support improving value in pharmaceutical spending. PBMs use their power to get drugmakers to offer discounts and rebates on their products.

Federal and State governments are ineffective due to the heavy influence from the pharmaceutical industry lobby. Public records show between 199-2018, the industry paid more than $4.7 billion for federal impact and about $877 million for states. $399 million (45.5%) was paid to California alone. (Wouters, 2020)

PBM income from rebate cash flow has increased over the past seven years. However, employers, independent pharmacies, and consumers are not experiencing decreased prices.

Some consumer advocates criticize PBMs for not passing along the savings they achieve. Others argue that PBMs play a significant role in keeping prescription drug costs in check. PBM income from rebate cash flow has increased over the past seven years. However, employers, independent pharmacies, and consumers are not experiencing decreased prices.

Why are rebate payments to PBMs controversial?

The controversy is over the fact that the PBMs receive rebates from drug companies in exchange for the PBMs’ use of the drug company’s medications. PBMs are working as a middleman, taking money from drug companies, and giving their clients a portion of that money.

PBMs counter that they have passed along a larger share of the rebates to insurers. There is much debate over whether PBMs should keep the undisclosed rebates obtained from drug manufacturers. 

Some support compelling PBMS to “pass-through” all or a more sizable portion of these savings to health insurers and other payers. 

 PBM income from rebate cash flow has increased over the past seven years. However, employers, independent pharmacies, and consumers are not experiencing decreased prices. 

“Spread Pricing” is when PBMs hedge their investment with drug manufacturers. Employers and health plans pay PBMs one price, while PBMs pay a different fee to pharmacies. PBMs make money on the difference or “spread” between the two cash flows!

How do PBMs impact the VA (Veteran’s Administration)?

The Pharmacy Benefit Management system’s influence on the VA impacts the cost of prescription medications. The VA negotiates prices directly with drug manufacturers, but no such privilege exists in the civilian system. 

The desperate systems result in medication dispensed by the VA amounts to about half the cost of civilian prices. Prices would decrease if civilians negotiated with the manufacturers

What are added functions of pharmacy benefit managers?

Pharmacy Benefit Managers (PBMs) administer prescription drug plans and negotiate prices between pharmaceutical manufacturers, pharmacies, and health insurance companies. 

PBMs can be both for-profit and non-profit companies. They can be corporations, trusts, limited liability companies, or partnerships.

Pharmacy benefit managers conduct business as intermediaries to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate prices between pharmacies and health plans.

Pharmacy Benefit Managers (PBM) are large companies that oversee prescription drug benefits for insurance plans. PBMs are unregulated. It is time for PBM reform. Companies that use PBMs to manage their prescription drug benefits are often unaware of the actual cost of the drugs.

Since PBMs oversee negotiating with pharmacies, they often force the pharmacy to charge costs that insurance plans will reimburse at a much higher price than if someone just paid out of pocket.

PBM is short for Pharmacy Benefits Manager, which handles prescription drug benefits for insurance plans. They help negotiate prices with pharmacies and create formularies to decide which drugs are covered by an insurance plan.

How would consumers recognize the PBM marketplace?

PBMs are unrecognized by most employees and even many employers. PBMs determine which pharmacies to include in a prescription drug plan’s network and how much they will pay for their services.

They also determine which medications will be covered by the plan or plan formulary, and drug manufacturers often pay “rebates” to PBMs to get their drugs onto those formularies. The PBM market reaches more than 280 million insured American consumers but is quite secretive about business transactions. (PBM ABUSES, n.d.)

PBMs leverage this backing to negotiate with drug manufacturers by demanding discounts on drugs in exchange for putting the manufacturer’s drugs in front of millions of customers. Furthermore, PBMs negotiate contracts with pharmacies to create networks of retail pharmacies for drug distribution. (Du & Schmitt, 2021)

PBMs are unrecognized by most employees and even many employers. PBMs determine which pharmacies to include in a prescription drug plan’s network and how much they will pay for their services.

They also determine which medications will be covered by the plan or plan formulary, and drug manufacturers often pay “rebates” to PBMs to get their drugs onto those formularies. The PBM market reaches more than 280 million insured American consumers but is quite secretive about business transactions.(PBM ABUSES, n.d.)

PBMs leverage this backing to negotiate with drug manufacturers by demanding discounts on drugs in exchange for putting the manufacturer’s drugs in front of millions of customers. Furthermore, PBMs negotiate contracts with pharmacies to create networks of retail pharmacies for drug distribution. (Du & Schmitt, 2021)

What are the sources of income in the PBM market?

PBMs are unrecognized by most employees and even many employers. PBMs determine which pharmacies to include in a prescription drug plan’s network and how much they will pay for their services.

They also determine which medications will be covered by the plan or plan formulary, and drug manufacturers often pay “rebates” to PBMs to get their drugs onto those formularies. The PBM market reaches more than 280 million insured American consumers but is quite secretive about business transactions. (PBM ABUSES, n.d.)

PBMs leverage this backing to negotiate with drug manufacturers by demanding discounts on drugs in exchange for putting the manufacturer’s drugs in front of millions of customers. Furthermore, PBMs negotiate contracts with pharmacies to create networks of retail pharmacies for drug distribution. (Du & Schmitt, 2021)

What are the sources of income in the PBM market?

The PBM industry is a multibillion-dollar industry formed to help pharmaceutical companies avoid the prohibitive costs of drug manufacturing. PBM companies should reduce costs by purchasing drugs from pharmaceutical companies and then reselling them to pharmacies. (Pharmacy Benefit Managers and Their Role in Drug Spending | Commonwealth Fund, 2019)

PBMs make money through service fees, contract negotiation, processing prescriptions, and operating mail-order pharmacies. Large insurance companies give PBMs power when negotiating with drug manufacturers and pharmacies.

Competition is fierce among PBMs for contract negotiations with insurance companies. Consolidation allows PBMs to increase in size and negotiate better deals with drug manufacturers and pharmacies.

Why are PBMs condemned in healthcare?

The criticism of PBMs is that they put the interests of the pharmaceutical companies above patient needs. PBMs negotiate with pharmaceutical companies on behalf of the patients, and the pharmaceutical companies can pay less for their medications. (COMMENTARY: Congress Needs to Push down Drug Prices | Las Vegas Review-Journal, n.d.)

PBMs are common targets of lawsuits and government scrutiny. State legislatures have been pushing for greater transparency and disclosure provisions to regulate these companies better. (Du & Schmitt, 2021)

All of this indicates the regulation of the PBM industry that could affect future profitability. PBMs are not transparent about how they price drugs.

PBMs receive a higher price for generic drugs from health plans and employers than they pay pharmacies for these drugs. PBMs keep the difference between the prices they receive and the prices they pay pharmacies confidential from health plans.

Why do people with health insurance have excessive medical bills?

man with a medical debt burden
man bending over to get money

There are many reasons insured consumers experience outrageous medical bills. Current trends toward shifting greater responsibility for cost-sharing are evident.

Cost-sharing takes many forms, including increased premiums, deductibles, and copayments. The veil of secrecy in healthcare is a major contributing factor.

What will lower the cost of healthcare in America?

Manufacturers say raising prices is the primary means of offsetting rebates and other fees. PBMs counter that they have passed along a larger share of the rebates to insurers.

There is much debate over whether PBMs should keep the rebates they receive from drug manufacturers, which are secret. A recent study found that the share of rebates PBMs passed through to insurers and payers increased from 78 percent in 2012 to 91 percent in 2016. (Pharmacy Benefit Managers and Their Role in Drug Spending | Commonwealth Fund, 2019)

Support to compel PBMs to “pass-through” all or a more huge portion of these savings to health insurers and other payers if they want to continue receiving them.

13 Ways to Save on Medical Bills

  • Comparison shop for services.
  • Negotiate prices for procedures and treatments.
  • Ask about discounts for cash payments.
  • Inquire about package rates for procedures or treatments.
  • Consider using a medical cost-sharing ministry.
  • Shop prices for care at different hospitals and clinics before treatment.
  • Check with alternative providers for costs or other primary treatments.
  • Request that the doctor sends prescriptions electronically to the pharmacy.
  • Use mail-order pharmacies whenever possible.
  •  Check your eligibility for social service programs.
  • Check with your employer to review coverage options for family members. 
  • Investigate purchasing a pre-paid plan that offers access to discounted fees.

Controlling Pharmacy Benefit Managers (PBMs)

There is growing support for States and the Federal government to regulate these companies. Thoughts include imposing restrictions on executives like financial advisors’ legal obligation to work in the best interest of their clients.

What can bring down the cost of healthcare in America?

Pharmaceutical manufacturers say they raise the price of drugs to cover the cost of rebates. PBMs such as Express Scripts claim rebates are a response to rising list prices and are not the cause of them.

The complex pricing structure of the formulary can have unexpected consequences. Some methods to reduce the prohibitive costs of pharmaceuticals include:

  • State and federal legislation banning “gag clauses” is one way to bring down the cost of healthcare. Gag clauses prevent pharmacists from telling consumers about lower prices for prescription drugs without insurance claims.

Six states have passed legislation making gag clauses illegal as of 2017, and a federal ban on gag orders for private insurance went into effect in October 2018.

Conclusion

Drug price transparency enables consumers to make accurate choices when shopping for medications. Prescription drugs are like any other commodity. The covert method of doing business must end.

The industry must conduct business in daylight rather than in the shadows. Informed consumers can force change by taking action.

Pharmacy Benefit Managers provide benefits while often working to the detriment of consumers. You must preserve your access to healthcare at reasonable costs.

America’s healthcare delivery system is a secretive multi-billion-dollar industry. A transparent pricing system based upon vigorous competition among providers is mandatory.

Legislation is not the answer short-term. The decades-old way of pricing and delivering healthcare has deep roots.

Consumers can fight back through situational awareness. The Discovery of fair pricing of healthcare is impossible. An absence of transparency is the culprit.

Healthcare costs are influenced by many factors. Some people believe that increasing competition among healthcare providers will bring down the cost of healthcare.

PBMs do not manufacture prescription medications. PBMs do not sell prescription medications. Consumers can reduce the price of healthcare by exploring the following activities:

  • Become familiar with your health plan Formulary
  • Determine how the Tier system works
  • Find out how therapeutic equivalents can achieve lower cost results
  • Discuss less expensive treatments with your prescriber

Others believe that government intervention is necessary to bring down the cost of healthcare. Government is an unlikely ally. The healthcare lobby is well-funded and a formidable foe.

Some believe consumers can drive prices down if everyone takes responsibility for their health. Shopping for healthcare produces benefits with transparency in healthcare.

We hope you understand what is behind the inflated cost of prescription drugs. Contact us at (877) 436-9111 for a free 30-minute consultation to discuss your options if we can be of service.

ScriptSmart LLC is a patient advocate focused on healthcare cost reduction. We negotiate the cost of healthcare down for consumers requiring our services.

We negotiate the reduction of your out-of-pocket costs of healthcare. Thank you for being so interested in ScriptSmart LLC!

SOURCES:

COMMENTARY: Congress needs to push down drug prices | Las Vegas Review-Journal. (n.d.). Retrieved January 26, 2022, from https://www.reviewjournal.com/opinion/commentary-congress-needs-to-push-down-drug-prices-1683033/

Du, J., & Schmitt, K. R. (2021, June 11). Pharmacy Benefit Management Industry Definition. Investopedia. https://www.investopedia.com/articles/markets/070215/what-pharmacy-benefit-management-industry.asp#citation-3

Fein, A. J. P. . (2021, April 6). Drug Channels: The Top Pharmacy Benefit Managers of 2020: Vertical Integration Drives Consolidation. Drug Channels. https://www.drugchannels.net/2021/04/the-top-pharmacy-benefit-managers-pbms.html

Hedt, S. (2020, February 11). New Evidence Shows Prescription Drug Rebates Play a Role in Increasing List Prices – USC Schaeffer. USC Schaeffer. https://healthpolicy.usc.edu/article/new-evidence-shows-prescription-drug-rebates-play-a-role-in-increasing-list-prices/

Herman, B. (2018). How big consulting firms and PBMs work the drug pricing system – Axios. Axios. https://www.axios.com/big-consultants-pbms-drug-prices-employers-16f1c0c1-b1b8-4b7b-9f00-149fe2f7201f.html

Maverick, J. B., & Munichiello, K. (2021, September 23). Who Are Willis Towers Watson’s Main Competitors? Investopedia. https://www.investopedia.com/articles/insights/080116/who-are-willis-towers-watsons-main-competitors-wltw.asp

PBM ABUSES. (n.d.). Retrieved January 26, 2022, from www.jamainternalmedicine.com.

Pharmacy Benefit Managers and Their Role in Drug Spending | Commonwealth Fund. (2019, April 22). Commonwealth Fund. https://www.commonwealthfund.org/publications/explainer/2019/apr/pharmacy-benefit-managers-and-their-role-drug-spending

Prescription Drug Spending | U.S. GAO. (n.d.). Retrieved January 18, 2022, from https://www.gao.gov/prescription-drug-spending

Seeley, E., & Kasselheim, A. S. (2019, March 26). Pharmacy Benefit Managers Practices Controversies What Lies Ahead | Commonwealth Fund. Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2019/mar/pharmacy-benefit-managers-practices-controversies-what-lies-ahead

Top Insurers Move to Bring PBM Partners In-House | Ritter Insurance Marketing. (n.d.). Retrieved January 18, 2022, from https://www.ritterim.com/blog/top-insurers-move-to-bring-pbm-partners-in-house/#agent-survival-kit

Wouters, O. J. (2020). Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999-2018. JAMA Internal Medicine, 180(5), 1. https://doi.org/10.1001/JAMAINTERNMED.2020.0146

Share:

Share on facebook
Facebook
Share on twitter
Twitter
Share on pinterest
Pinterest
Share on linkedin
LinkedIn
On Key

Related Posts

Scroll to top button
Share on facebook
Share on twitter
Share on linkedin
Share on pinterest