Money from sick people

We rely heavily on generic and biosimilar competition to evaporate the costs of expensive brand-name drugs.

But when a big PBM picks a winner before the competitive race to the bottom can even conclude, inflated prices become entrenched. Zach Brennan endpts.com/sandozs-humira…

Last fall we worked with @wsj to illuminate the massive mark-ups that big PBMs were slathering on top of cheap generic “specialty” drugs.

The findings prompted Elizabeth Warren Senator Mike Braun to call for an OIG investigation.

The probe is on. wsj.com/livecoverage/s… Jen Calfas Mark Cuban

Mark Cuban For those interested in the data Antonio Ciaccia and 3 Axis Advisors called attention to it a few years back

3axisadvisors.com/projects/2020/…

'There’s a certain irony in 'inflation reduction' legislation leading to massive price increases.' Brian Reid

costcurvenews.com/2024/04/11/wor…

Always love hearing what’s rolling around in the great legal mind of Greg Reybold.

MedPAC wants to know why the prices yielded by PBMs at the pharmacy counter are set in a casino-like fashion.

Maybe because it is a casino. medpagetoday.com/publichealthpo… MedPage Today MedPAC Mark Cuban Cost Plus Drug Company Mark Cuban Alex Oshmyansky, MD, PhD

PBMs were center stage on yesterday’s CBS Sunday Morning 🌞 for being next in the crosshairs of Lina Khan cbsnews.com/amp/news/feder…

Pharmacy benefit manager Express Scripts by Evernorth is requesting that a lawsuit filed against the company and others last month over the price of insulin in Indiana state court be tried instead before a federal judge.

news.bloomberglaw.com/health-law-and…

I often get asked, “How does GoodRx make money?”

Here is an outstanding explainer on just one of the ways. youtu.be/NWJ9ZqxssWw?fe…

Hell of a story 👇

Humira biosimilar non-coverage shines a bright spotlight on the issue but unfortunately this practice of excluding generics in favor of brand name drugs is not new - check out study itmedicalteam.pl/articles/analy…

The largest PBMs are avoiding covering the lowest-priced version of the best selling drug of all time.

We have a drug problem in the United States, but it’s not the one you may think it is.

Essential report from Adam J. Fein highlighting the latest market share distribution and trends in the ever-growing and evolving pharmacy benefits management industry drugchannels.net/2024/04/the-to…

A brand drugmaker raised the list price of a medicine by 486% to ensure supply amid drug shortage issues.

Justified or not, the hike raises questions about how government inflation penalties may exacerbate cost burdens for commercial plans. pharmalot statnews.com/pharmalot/2024…

'For complicated policy reasons, pharmacy benefit managers make more money from Humira than they do biosimilars, so PBMs favor the branded Humira by giving them better formulary placement compared to biosimilars.' - John Wilkerson

statnews.com/2024/04/04/boe…

My good friend Joe Craft had to shut down his central Ohio community pharmacies due to a no longer viable business model despite increased revenue and prescription volume.

We get what we pay for. 10tv.com/article/money/… Kevin Landers Attorney General Dave Yost NCPA

“The only way to fix it is to dredge it out and start over. That’s where we are with our healthcare system when it comes to PBMs.” - Attorney General Dave Yost