One could make an argument for drug prices being high from the manufacturer, due to costs to develop new drugs. It’s a stupid argument, as it doesn’t apply in the rest of the world, but has some element of rationality to it. However PBMs exist solely to handle the drugs from point A to point B. And often not even literally - they just manage the process. So rationale for making a fuckton of money? I don’t see it…
I used to work for one of these wretched PBM companies for just under a year. The whole business model was a middleman sleight-of-hand cash grab.
The CFO and IT manager were colluding in some PBM money skimming scheme. I knew the company was putting itself up for sale, and I knew something sketchy was going on by the way the numbers kept getting rearranged. I was a potential whistleblower and got laid off before I figured out exactly what was happening. But someone else blew the whistle after I was canned. The story made it into the local news.
I had a knee replaced this year. I paid for my pain medication AFTER I was discharged from hospital (over the counter meds too, not the really strong stuff) cos everything else was covered by my sochulism hell hole health system - tell me i'm worse off than the land of the freedumbs...
Speaking of middlemen, in GA, stores and bars can't buy directly from brewers and distillers. Distributers have to be involved by law and once they have a relationship with a producer the producer can't move. Crazy.
Well, that's because liquor is the Debbil's Tool (along with playing cards, dancing, pool, and sex). The Debbil is the distributor, and once the Debbil has you, there is no way out unless you come to Jeebus and stop being a producer.
I have been given a prescription for cyclosporine eyedrops. Without insurance Vevye (2ml bottle) is 755 dollars. Of course the price goes down with insurance, but that is much more than what I pay since I have health insurance. Now you tell me how cyclosporine eye drops are worth nearly 800 dollars for 2 milliliters (0.0002), except for a hefty markup. I can tell you this, Joe Biden is NOT to blame for this inflationary practice. It is vulture Capitalism in the healthcare industry. It is not gold, or mined only on the moon, just a common antibiotic.
Prescription Profiteering Managers. I remember reading an article in the 1990s about Japan's economic bust, bragging in a moderately racist way that America would never fail like that because we don't have an economy riddled with corrupt middlemen.
My fondest hopes for the ACA were a public option or lowering the age for Medicare. I was in my early 50s at the time and paying through the nose for private insurance and medications. Healthcare shouldn’t be tied to your employer, who is either shopping for the cheapest plan possible or using decent health insurance as a recruiting tool.
I was thinking the other day about all the industries with pointless middlemen. Pharmacy obvs but also credit cards, the food industry (parts of it anyway), title companies for real estate (is there any earthly reason the government can't supply this service). I'm sure there are many others, this being America and all.
If there's a way to make an extra buck off something, someone in America has weaseled themselves into position to do it. The public welfare or greater good don't bring home the bacon, baybee, so to hell with those ideas.
Thanks Robyn for explaining this complicated topic. The only think I can't figure out is why the anti-PBM people have been saturating my news radio station with advertising saying to get rid of PBM's. Usually that means than an even bigger, worser corporate monopoly is trying to leverage their advantage in this situation and is willing to spend serious money to get their point across.
I've been wondering about those ads too. When I worked for a PBM, many were essentially in bed with each other (CVS, Optum). Now it seems like they are eating their own middlemen cash cow and hoping that the drug prices will stay the same so more profit$$$.
Worth noting, of course, is that the big insurance companies OWN the big PBM companies. They're literally taking from Peter to pay Paul - with your money.
Cost Plus Drugs, the philanthropy pharmacy website from Mark Cuban, is an online pharmacy that cuts out the PBM entirely and sells drugs direct from manufacturer with only the pharmacy itself as the middleman instead of the extra 2-3 layers that the standard pharmacy model has.
I remember the PBMs whining like little babies over this. Apparently Lina Khan is just SO BIASED against them that it could never ever be fair to charge them while she leads the FTC.
What I'm hearing is we need to make sure she keeps chairing it for a good while yet.
One could make an argument for drug prices being high from the manufacturer, due to costs to develop new drugs. It’s a stupid argument, as it doesn’t apply in the rest of the world, but has some element of rationality to it. However PBMs exist solely to handle the drugs from point A to point B. And often not even literally - they just manage the process. So rationale for making a fuckton of money? I don’t see it…
Except that a lot of drug R&D is done with funding from grants from entities like the NIH, so taxpayer money. They get us coming and going
As I said, a stupid argument, for a number of reasons.
"... a double Cincinnati time step."
And all we want PBMs to do is a "shuffle off to Buffalo..."
I used to work for one of these wretched PBM companies for just under a year. The whole business model was a middleman sleight-of-hand cash grab.
The CFO and IT manager were colluding in some PBM money skimming scheme. I knew the company was putting itself up for sale, and I knew something sketchy was going on by the way the numbers kept getting rearranged. I was a potential whistleblower and got laid off before I figured out exactly what was happening. But someone else blew the whistle after I was canned. The story made it into the local news.
I had a knee replaced this year. I paid for my pain medication AFTER I was discharged from hospital (over the counter meds too, not the really strong stuff) cos everything else was covered by my sochulism hell hole health system - tell me i'm worse off than the land of the freedumbs...
Oh. So perhaps THIS is why my blood sugar medication all of a sudden costs FOUR TIMES AS MUCH as it did four months ago.
Fudge. I'm so sorry, that sucks.
Speaking of middlemen, in GA, stores and bars can't buy directly from brewers and distillers. Distributers have to be involved by law and once they have a relationship with a producer the producer can't move. Crazy.
Well, that's because liquor is the Debbil's Tool (along with playing cards, dancing, pool, and sex). The Debbil is the distributor, and once the Debbil has you, there is no way out unless you come to Jeebus and stop being a producer.
I have been given a prescription for cyclosporine eyedrops. Without insurance Vevye (2ml bottle) is 755 dollars. Of course the price goes down with insurance, but that is much more than what I pay since I have health insurance. Now you tell me how cyclosporine eye drops are worth nearly 800 dollars for 2 milliliters (0.0002), except for a hefty markup. I can tell you this, Joe Biden is NOT to blame for this inflationary practice. It is vulture Capitalism in the healthcare industry. It is not gold, or mined only on the moon, just a common antibiotic.
Two damn ml, that's insane!
In two words: Price gouging.
Lina Khan is essentially a god.
Ta, Robyn. Another useless layer of corporate greed.
U.S.A #1 in corporate greed.
Prescription Profiteering Managers. I remember reading an article in the 1990s about Japan's economic bust, bragging in a moderately racist way that America would never fail like that because we don't have an economy riddled with corrupt middlemen.
Geez, the entire US o' A's economy has always been riddled with corrupt middlemen, a.k.a. "The Free Market."
"Who wrote it" was the first question that jumped to mind
My fondest hopes for the ACA were a public option or lowering the age for Medicare. I was in my early 50s at the time and paying through the nose for private insurance and medications. Healthcare shouldn’t be tied to your employer, who is either shopping for the cheapest plan possible or using decent health insurance as a recruiting tool.
I was thinking the other day about all the industries with pointless middlemen. Pharmacy obvs but also credit cards, the food industry (parts of it anyway), title companies for real estate (is there any earthly reason the government can't supply this service). I'm sure there are many others, this being America and all.
If there's a way to make an extra buck off something, someone in America has weaseled themselves into position to do it. The public welfare or greater good don't bring home the bacon, baybee, so to hell with those ideas.
Thanks Robyn for explaining this complicated topic. The only think I can't figure out is why the anti-PBM people have been saturating my news radio station with advertising saying to get rid of PBM's. Usually that means than an even bigger, worser corporate monopoly is trying to leverage their advantage in this situation and is willing to spend serious money to get their point across.
I've been wondering about those ads too. When I worked for a PBM, many were essentially in bed with each other (CVS, Optum). Now it seems like they are eating their own middlemen cash cow and hoping that the drug prices will stay the same so more profit$$$.
Worth noting, of course, is that the big insurance companies OWN the big PBM companies. They're literally taking from Peter to pay Paul - with your money.
Cost Plus Drugs, the philanthropy pharmacy website from Mark Cuban, is an online pharmacy that cuts out the PBM entirely and sells drugs direct from manufacturer with only the pharmacy itself as the middleman instead of the extra 2-3 layers that the standard pharmacy model has.
I remember the PBMs whining like little babies over this. Apparently Lina Khan is just SO BIASED against them that it could never ever be fair to charge them while she leads the FTC.
What I'm hearing is we need to make sure she keeps chairing it for a good while yet.