Anti-Trust

In the U.S., a consumer will go into a drug store, in this case Walgreens, after their doctor prescribes medication, and then the consumer will make a copayment. A Walgreens pharmacist then dispenses it. After doing so, Walgreens gets a set reimbursement from that consumer’s insurance company for that medication. How much does it get? Well, those insurance company’s contract with what’s called pharmacy benefit managers (PBM) to manage negotiations with pharmacies. A PBM sets up a network for insurance companies, manages drug prices, and handles all the payment logistics between patients and pharmacies. PBMs negotiate with pharmacies, and set up a pricing agreement on which drugs are covered and how much those pharmacies get reimbursed in return for allowing those pharmacies to serve its customers.

Reads like parody.