Pharmacy benefit managers (PBMs) are under scrutiny for driving up drug costs by steering patients towards pricier drugs, charging steep markups, and extracting hidden fees. The New York Times investigation reveals how PBMs affect millions of Americans and the healthcare system, leading to serious health consequences and financial burdens. The largest PBMs, owned by CVS Health, Cigna, and UnitedHealth Group, oversee prescriptions for over 200 million Americans, impacting insurance premiums, taxes, and access to medications. Employers switching to mail-order pharmacies owned by PBMs have experienced significantly higher markups, contributing to escalating drug costs.
“It’s absolutely not fair.” Employers find that mail-order pharmacies, which they were told would help save money on workers’ prescriptions, are contributing to higher drug costs. https://t.co/ic6TkDpX3B via @WSJ
"I would like to see what’s the true cost of the medication, & what’s the difference between us going to our local pharmacy versus going to mail order,” said Steve Gordon, chief financial officer of Anderson Hay & Grain in Ellensburg, Wash. Anderson’s drug-benefit spending has… https://t.co/06Bcqhi6B0
"Many PBMs, including the 3 largest, also own a mail-order pharmacy. In those cases, the PBM effectively sells a drug to itself. They can make a larger spread by marking up how much the health plan pays to the PBM, employers & benefits consultants said." https://t.co/6b0zBJPzmr
Branded drugs filled by mail were marked up on avg 3X to 6X higher > cost of medicines dispensed by chain & grocery-store pharmacies, & roughly 35X > than those filled by independent pharmacies, according to the analysis, which looked at 2.4 million claims by self-insured… https://t.co/06Bcqhi6B0
Branded drugs filled by mail were marked up on avg 3 to 6X higher > cost of medicines dispensed by chain & grocery-store pharmacies, and roughly 35X > than those filled by independent pharmacies, according to the analysis, which looked at 2.4 million claims by self-insured… https://t.co/06BcqhiEqy
Markups were as much as 35 times higher than what other pharmacies charged, according to a recent analysis of millions of prescriptions in Washington state. “It’s absolutely not fair, & it’s not saving us money,” said Lisa Nelson, Unity Care’s chief pharmacy officer in WA state https://t.co/06Bcqhi6B0
Employers were told they could reduce prescription drug spending for employees if they switched to mail order pharmacies owned by PBMs, story by @JaredSHopkins explains how instead it's driving up what they spend. https://t.co/7EDJjHdsPW Markups were as much as 35 times higher!
PBMs often promise employers big savings by pushing patients to use mail-order pharmacies that are owned by the PBM’s parent company. Our new study found that employers were charged mail markups that were at least triple the cost at retail @JaredSHopkins https://t.co/IpYqJJMc6Z
“It’s absolutely not fair.” Employers find that mail-order pharmacies, which they were told would help save money on workers’ prescriptions, are contributing to higher drug costs. https://t.co/lCaKoZh4hq
"pharmacies nationwide have been complaining about diminishing reimbursements & clawbacks from middlemen who control access to so many insured patients that pharmacies believe they have no choice but to contract with them. The biggest 3 [PBMs] are estimated to control access to… https://t.co/MnW5Lxipq2
🇺🇸 A Shadow Industry ▫Pharmacy benefit managers are driving up drug costs for millions of people, employers and the government ▫@RebeccaDRobbins @ReedAbelson ▫https://t.co/YAeBOMrIAy 👈 #frontpagestoday #USA @nytimes 🇺🇸 https://t.co/9OEC2uk90E
“The three largest pharmacy benefit managers, or P.B.M.s, act as middlemen overseeing prescriptions for more than 200 million Americans. They are owned by huge health care conglomerates — CVS Health, Cigna and UnitedHealth Group — and are hired by employers and governments. The… https://t.co/fLsKiqvoFS
Pharmacy benefit managers are driving up drug costs for millions of people, employers and the government. https://t.co/E0C3f0RFwT
Pharmacy benefit managers are driving up drug costs for millions of people, employers and the government. New York Times pharmaceutical reporter, Rebecca Robbins, explains how. https://t.co/F5XW9dZCx7
Pharmacy Benefit Managers (PBMs) are the middlemen of the healthcare industry. They drive up drug costs, bankrupt neighborhood pharmacies & distort the system. I’m authoring the most comprehensive PBM regulatory legislation in the US. SB 966 is receiving broad bipartisan support https://t.co/jObMKc0ilc
Here’s what to know about your pharmacy benefit manager and how to find out if you are being overcharged for medications. https://t.co/1g10HUHfs0
Worth reading: A highly critical article from @NYTimes arguing that #PBMs "are driving up drug costs for millions of people, employers and the government." @RebeccaDRobbins @ReedAbelson https://t.co/jiTLl7g7TV
Opinion | PBMs promote greater competition in the drug market and on the pharmacy level, helping patients save on drug costs, which is why Big Pharma and other special interests are fixated on scapegoating them: It would boost their own bottom line. https://t.co/CCKBb8V2th
I didn’t know much about PBMs; this was a helpful article explaining how they are generating huge profits while driving up the costs of medications for governmental insurance programs and patients https://t.co/PYhdKKuZsn
This @nytimes piece from @ReedAbelson and @rebeccadrobbins gets to the heart of the PBM issue: the industry is using complex corporate engineering to suck dollars out of the system, dollars that could otherwise help reduce costs for patients. https://t.co/utoL97p9Pu @BiotechCH
If you’ve ever had trouble getting a prescription drug, chances are you’ve run into a pharmacy benefit manager. Here’s what to know about your PBM and how to find out if you are being overcharged. https://t.co/yBVZc1tEKy
If you’ve ever had trouble getting your prescriptions, chances are you’ve run into a pharmacy benefit manager. Here's what to know about them, and how to find out if you're being overcharged. https://t.co/P33Oi4Lk2K
Comments by former US senator on today's prescription drug insurance/PBM story who is very passionate about defending PBMs. https://t.co/duPhVDl3g8
Last tweet from me for now on this prescription drug insurance story, the story also discusses the offshore subsidiaries set up in '18 as an alleged legal strategy to avoid giving the drug manufacturers' discounts to the employers who hired PBMs to get discounted drug prices.… https://t.co/S9TMNVsowY
"The steepest markups [by prescription drug insurance/PBMs] often involve generic versions of expensive medications for conditions like cancer." https://t.co/gd34SXZ90p
"One surefire way for the PBM or its in-house pharmacy to profit is to charge thousands of dollars more than what a drug costs. The Times identified repeated instances of PBMs doing just that." More below: https://t.co/S9TMNVsowY
"The 3 PBMs [insurance] push, & sometimes force, patients to use their pharmacies, whether mail-order or, in CVS’s case, the physical drugstores. One common strategy is to not allow patients to receive 90-day supplies of drugs if they fill prescriptions at outside pharmacies." https://t.co/S9TMNVrQHq
"the PBMs’ business practices touch virtually every American family. Even people who don’t take prescription drugs end up paying higher insurance premiums and taxes as a result of inflated drug costs." https://t.co/S9TMNVrQHq
"PBMs sometimes delay or even prevent patients from getting their prescriptions. In the worst cases, patients suffer serious health consequences," from @RebeccaDRobbins @ReedAbelson story below: https://t.co/55IlE8Wv3L
"The PBMs, which are responsible for paying pharmacies on behalf of employers, are driving independent drugstores out of business by not paying them enough to cover their costs. Small pharmacies have little choice but to accept these lowball rates because the largest PBMs… https://t.co/S9TMNVrQHq
More on prescription drug insurance companies/PBMs, "They often charge employers & government programs like Medicare multiple times the wholesale price of a drug, keeping most of the difference for themselves. That overcharging goes far beyond the markups that pharmacies, like… https://t.co/S9TMNVrQHq
"The job of the PBMs is to reduce drug costs. Instead, they frequently do the opposite. They steer patients toward pricier drugs, charge steep markups on what would otherwise be inexpensive medicines & extract billions of dollars in hidden fees, a NY Times investigation found" https://t.co/S9TMNVrQHq
"And they are driving up drug costs for millions of people, employers & the government. The 3 largest pharmacy benefit managers, or P.B.M.s, act as middlemen overseeing prescriptions for more than 200 million Americans." https://t.co/S9TMNVrQHq
The @nytimes pulled back the curtain on the shady practices of PBMs. These middlemen decide what medicines patients can get and at what cost. They pocket savings meant for patients and are “driving up drug costs for millions of people, employers and the government.” Policymakers… https://t.co/Xh0DBunAZN https://t.co/zkVNuPP8bS
The job of pharmacy benefit managers is to reduce drug costs. Instead, they steer patients toward pricier drugs, charge steep markups on what would otherwise be inexpensive medicines and extract billions in hidden fees, The New York Times found. https://t.co/TNzQOfimsl
For the past year, @ReedAbelson and I have been reporting on the big pharmacy benefit managers. In a story published today, we tried to clearly explain what these companies do — and how they affect how much everyone spends on prescription drugs. https://t.co/KtrqreaRAZ
Pharmacy benefit managers act as middlemen overseeing prescriptions for millions of Americans to reduce drug costs. A New York Times investigation found they charge steep prices for patients, employers and the government. Our reporter explains how. https://t.co/vEwmFFI2Ou https://t.co/zqaqJn64Cn
Think meds cost too much? Must read! @RebeccaDRobbins & @ReedAbelson: pharmacy benefit managers “operate in the bowels of the health care system & cloak themselves in such opacity & complexity that many ppl don’t even realize they exist.” #MedTwitter https://t.co/NNMeJIYnqt