PBMs’ markups are getting bigger

By Sam Baker

Pharmacy benefit managers’ role in the drug supply chain is incredibly opaque. But Bloomberg helps pull back the curtain a little bit more.

How it works: PBMs’ profit from the “spread” between the prices they charge their clients (insurance companies and employers) and what they actually pay pharmacies for drugs. But it’s usually impossible to know exactly what that spread is.

The latest details come from New York’s Medicaid program. A new analysis commissioned by independent pharmacists in the state, and shared with Bloomberg, found that PBMs’ markups doubled from 2016 to 2017…

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