How Pharmacy Benefit Managers Drive Up the Cost of Health Care
STORY-AT-A-GLANCE Pharmacy Benefit Managers (PBMs) evolved from simple claims processors into powerful health care intermediaries that control drug pricing and access through their relationships with insurers, pharmacies and drug manufacturers. PBMs engage in “spread pricing” — charging insurers more than they reimburse pharmacies and pocketing the difference — while also steering patients toward higher-cost medications […]
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