PBMs Play Monkey and the Middleman

For expensive medications, pharmacy benefit managers like Express Scripts are a “middleman” intended to ensure that patients will benefit from prescribed meds.

PBMs work supposedly to negotiate drug prices on behalf of insurance plans.

But, according to many, PBMs are getting undisclosed rebates from drug makers and create convoluted approvals processes. They drive up already high drug prices and often delay vital meds from getting to patients with complex illnesses like cancer.

The Quote: “A common pattern in American health care: Companies charge exorbitantly high prices, mysterious intermediaries stand to benefit and patients are caught in the crossfire.”

The Atlantic

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