While the pharmaceutical industry gains a brunt of the blame for high drug prices, pharmacy benefit managers tend to remain mostly out of the spotlight.
Sander Flaum, Flaum Navigators principal, shifts that spotlight in an article published Thursday on Medical Marketing and Media.
Flaum cites Mylan CEO Heather Bresch’s testimony to Congress in which she said more than half of EpiPen’s $608 list price actually went to middlemen, while the drugmaker pocketed about $50.
“Remember that PBMs began by providing a huge service to payers,” Flaum writes. “Organizing the delivery of prescription drugs, which had become far more complex than most providers could manage, was a huge contribution. But in recent years, PBMs have begun to suck revenue from pharma manufacturers without providing much in exchange.”
According to Flaum, Express Scripts, OptumRx and CVS Health collectively handle some 4 billion prescriptions each year, which amounts to about 3/4 of the market.