Blame Pharmacy Benefit Managers (Not Pharma) For Driving Drug Price Inflation

Summary: We start with a review of the history of the opaque pharmacy benefit manager (PBM) reseller business model. We present our prior estimates of the distribution of PBM gross profits over the past decade showing that they have become dependent today on retained rebates from specialty drugs. Next, we present numbers showing how PBMs […]

Pharmacy Benefit Managers

CURRENT PAPERS ON PBMs A Position Auction Demonstration Project for Lowering Reference + Biosimilar Rx Drug Prices in Medicare Part B  (8/19) Off-Target: Pelosi’s Binding Arbitration Proposal to Reduce Medicare Part D Drug Prices (04/19) Quantifying a Pharmacy Benefit Manager (PBM) Fee-For-Service Business Model   (03/19) CVS’s Negligent Handling of Its 2019 Formulary Change In Coverage […]

The Pharmacy Benefit Manager (PBM) Business Model

CURRENT PAPERS: Quantifying a Pharmacy Benefit Manager (PBM) Fee-For-Service Business Model (03/19) The Problem with CVS’s “Guarantee Net Cost” PBM Business Model (12/18) Three Phases of the Pharmacy Benefit Manager Business Model (09/17) Will Amazon’s Online Pharmacy Display Therapeutic Equivalents (12/17) Blame PBMs (Not Pharma) For Driving Drug Price Inflation (09/17) Merck Data Discredits PBM-Sponsored Study of […]

Preferred Provider Pharmacy Networks

PREFERRED PROVIDER PHARMACY NETWORKS The CVS-Caremark Merger and the Coming Preferred Provider War (12/06) Medicare Part D and Preferred Provider Pharmacy (04/05) The CVS-Caremark Merger: The Creation of an Elasticity of Demand for Retail Rx (11/06) Contrary to What Wall Street and the FTC Say, The PBM Business Model is Misaligned (11/05) Sins of Omission’: […]