PIPELINE TO PROFITS
A little more about that … Kaiser Health News infographic!
By Dr. David E. Marcinko MBA via Georgia Pharmacy Association
Recently, KHN ran an infographic from Kaiser Health News that gave a rough explanation of how the money flows in the sale of a brand-name drug.
After thinking about it a bit, Greg Reybold, Vice President of Public Policy & Association Counsel for the Georgia Pharmacy Association, noticed some fundamental flaws.
“The infographic helps shed light on a process that lacks fundamental transparency,” he said, “but it doesn’t reflect all of the practices engaged in by some PBMs.”
Furthermore, he added,
“There are times, unbeknownst to patients, when some PBMs charge patients copays that are significantly higher than the cost of the drugs themselves, or they steer patients to brand name drugs for which the PBM receives a rebate when there is a less costly generic available.”
He also noted the infographic:
“reflects that the pharmacy make a profit — when in fact there are many times pharmacies lose money on prescriptions they fill through low reimbursements, the imposition of different types of fees, and aggressive audits.”
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