PBMs blame insurers for high drug prices

Sky-high drug prices and healthcare costs have quickly turned into a voter issue in Washington, D.C., with politicians promising to go after pharmaceutical companies to lower prices. Pharmacy benefit managers (PBMs)—the industry middlemen that negotiate drug prices—are passing on nearly all their savings to insurance providers, according to Terry Wilcox, co-founder and executive director of advocacy organization Patients Rising. His op-ed for The Hill placed the blame of high costs squarely on insurers.

CVS Health reported it passed on 98 percent of rebates it receives from drug makers to insurers in 2018 disclosures, while Express Scripts passes on 95 percent of rebates to health plan clients and customers. These savings help subsidize premium costs for health plan members, but they also could be bolstering profits for insurers, according to Wilcox.

See the full story below:

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.