on Pharmacy Benefit Managers has authoritatively documented the multiple ways in which the three largest PBMs have contributed to the rising cost of drugs. This investigation has shown a spotlight on a list of questionable practices that have long been the subject of complaints from consumers, independent pharmacies, pharmaceutical manufacturers, employers and other stakeholders.
However, PBMs make their money through more than rebates—and to curb these perverse incentives, the FTC needs to explore other practices too.that PBM compensation from these fees doubled in just four years, skyrocketing from $3.8 billion in 2018 to $7.6 billion in 2022. These fees represent a strategy by PBMs to maintain their profit margins as traditional revenue streams have come under scrutiny.
The vertical integration of PBMs with pharmacy chains has created a closed loop of self-dealing. From selective contracting to patient steering and narrow networks, these behemoths are systematically funneling patients into their own ecosystems. PBMs reserve in-network status for pharmacy chains owned by their parent corporations, an obvious form of self-dealing that limits patient options and stifles competition.
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