As a consequence, PBMs’ earnings are enhanced when manufacturers charge high list prices, but then pay large rebates and discounts to lower the actual transaction prices, creating a strong financial incentive for PBMs to support the current opaque pricing system.
Ultimately, the complicated pricing structure for pharmaceuticals is problematic and diminishes the beneficial role prices typically play in a market economy. Therefore, pricing reforms are necessary to establish a simpler, transparent, pricing model for pharmaceuticals. The goal of such reforms should be to enable list prices that more accurately reflect actual transaction prices.
Patients, pharmacists and doctors will all benefit from better pricing information. Further, the PBMs that add value by creating purchasing efficiencies for their clients will still have an opportunity to thrive under a less complicated pricing structure. But, their profits will be solely based on providing value-added services.
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