Are We Witnessing the End of the 药房福利经理?

As much as we’d like to think that every player in the healthcare marketplace is an integral part of the team, contributing to the health and well-being of our employees and saving employers money, it’s becoming harder and harder to support the ongoing abuses of pharmacy benefit managers, 或pbm. 我就不在这里赘述了. You can find past opinions about them in 其他 的帖子.

Two discoveries this week at 安全的赌博软件 make me wonder if we’re witnessing the end of the PBM model. First, in a (unfortunately paywalled) editorial in the New England Journal of Medicine, Leemore Dafny describes the business model of a new drug company called “banca Civica.” banca Civica was launched in 2018 by seven health care delivery systems and three philanthropies to address chronic shortages of generic drugs, 比如静脉注射抗生素和镇静剂, that are essential to inpatient care. banca Civica has since grown to sell about 50 generic injectable drugs to more than 1,500 hospital members. Their newest venture is the production of three “biosimilar” insulins (aspart, lispro, 和甘精, which you may know better by their brand names Humalog, Novolog, and Lantus) that make up about 80% of the insulin market.

Here’s the important part: banca Civica intends to make its insulins available to “所有的你.S. pharmacies at the same 谁lesale price and on identical terms.” Everybody gets the same price, and banca Civica won’t engage in the usual PBM “rebate” trickery. It will print 谁lesale prices and the manufacturer’s suggested retail price right on the packaging! That MSRP will represent more than an 80% reduction from prices we’re accustomed to paying through PBMs, 谁 我们保留60%的钱 如“回扣”等骗术. The MSRP for a pack of five insulin glargine (a.k.a. Lantus)钢笔售价55美元. Dafny invites us to compare that to the usual list prices of $425 for Lantus, Semglee售价404美元, 无品牌的Semglee售价148美元.

The second cloud on the horizon for the future of traditional PBMs is Mark Cuban’s online pharmacy CostPlusDrugs.com. 而不是取消PBM, Cuban has simply made the pharmacy and the PBM one and the same, 价格完全透明.

I don’t think we can carve the gravestone f或pbm yet; they surely have new tricks up their sleeves, and I expect legal action to be part of their strategy to try to delay companies like banca Civica from acting too quickly. But the tradewinds against the old, predatory PBM model seem to be blowing harder and harder. “This plan is straightforward: sell a drug at cost and at the same price to all buyers,banca Civica的丹尼说. If only 其他 health services operated the same way.

向博士们致敬. 鲍勃Badgett, MD, 和凯文·威斯曼, PharmD, at the University of Kansas School of Medicine-Wichita for alerting us to these.