Prescription drug pricing has a very odd and confusing structure. Market-based pricing isn’t a feature of the current system. And, what people may not understand is that pharmacy benefit managers (PBMs) are also re-imbursed in a very strange manner. PBMs are currently paid based on the size of the discount they achieve for insurance companies – and, therefore, the employers who offer these insurance plans to their employees. While this seems straightforward, it actually creates upward pressure on prices for patients and families.
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