Some private insurance providers sponsoring Medicare Part D marked up certain generic drugs an average of five times what it costs to acquire the drug.
Some private insurance providers sponsoring Medicare Part D marked up certain generic drugs an average of five times what it costs to acquire the drug, data from the Centers for Medicare & Medicaid Services (CMS) show.
The data were presented in a research letter published in the Journal of the American Medical Association (JAMA) on Dec. 5 in an evaluation by researchers at the University of California–San Diego, West Health Policy Center in Washington, D.C., and the University of Washington.
How Prescriptions Work
Pharmacy benefit managers (PBMs) are companies that manage prescriptions for health insurers. They’re the middlemen, so to speak, between the drug manufacturer, the pharmacy, and the patient, determining the total drug cost for insurers, shaping total costs for patients, and establishing how much a pharmacy will be paid.
A.C. Dahnke
Author
A.C. Dahnke is a freelance writer and editor residing in California. She has covered community journalism and health care news for nearly a decade, winning a California Newspaper Publishers Award for her work.
