According to the article, Pharmacy Benefit Managers are as much to blame for the increasing costs of drugs as the manufacturers. I suspect that's partly true, but I also suspect the "percentage of blame" is being ignored here.
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A model that is more direct from business to customer sounds like it would eliminate costs. Too many people trying to put themselves in the middle and make a cut.
No offense, but the article got PBMs entirely wrong.
Any savings from rebates is typically passed back to the one paying. In fact, it would be odd if an insurance company didn't have that in their contract.
I'd say PBMs have done a ton on keeping drug costs down. Hell, look at HCV! Express Scripts cut a deal with Abbvie on their new HCV drug and excluded Solvadi and Harvoni from their formulary.
What happened? Gilead came out and offered a 20-30% discount on their drug to pretty much every other PBM and insurance company.
Who cares about the percentage of blame? I think to start reducing costs in our health care system we have to fix every problem we see.
Theoretically, the entity exists to work on behalf of the patient. A simple fix here would be to require them to pass any rebates they receive on to patients. That the rebates would go away under such a requirement is, uh, fine.