Drug Pricing
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Scrutinizing the Role of Pharmacy Benefit Managers
Policymakers should consider increasing transparency, explore alternatives to the rebate system, scrutinize vertical integration, and seek better alignment of PBM incentives with patient and payer interests.
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PBM Market Concentration Varies Among Payer Types
A few pharmacy benefit managers dominate each of the payer markets, and the three biggest PBMs appear to be targeting different markets.
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Pharmacy Benefit Manager Market Concentration for Prescriptions Filled at US Retail Pharmacies
A few pharmacy benefit managers dominate each of the payer markets, and the three biggest PBMs appear to be targeting different markets.”
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Responding to Some ‘Inconvenient’ Truths About PBMs
The lack of transparency and inability of plan sponsors to assess how much pharmacy benefit managers generate in savings and how much they retain for themselves is the root issue.
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About this section
High pharmaceutical prices may garner headlines, but innovation must be appropriately incentivized to help solve healthcare’s intractable challenges. The Schaeffer Center connects industry, the academy and government to support the scientific and technological creativity that saves and improves lives — and spurs economic growth.
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State Mandates to Cap Out-of-Pocket Insulin Costs Are No Longer Necessary
State laws capping patients’ out-of-pocket insulin costs, though well-intentioned, have had limited impact.
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A Patient-Focused, Evidence-Driven Approach to PBM Reform
As policymakers consider reforms to the prescription drug supply chain, they should keep five principles in mind to ensure better outcomes for patients.
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Schaeffer Center Researchers Make an Impact in Washington
The USC researchers have testified before Congress and informed policymakers tackling drug prices, innovation and medical bills.
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A New Healthcare Valuation Model That Puts Patients First: Generalized Risk Adjusted Cost-Effectiveness (GRACE)
By recognizing that health is worth more to those who have less, GRACE provides a more equitable approach to value assessment and healthcare investments.
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Let the Market Determine Drug Prices – Not 19th Century Economics
In health care, the term “value” gets lobbed about quite loosely. It is easy to forget that centuries of economic thought have gone into rigorously examining how worth is determined in a marketplace.
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Medicare Coverage of Weight Loss Drugs Could Save the U.S. Billions of Dollars
The new weight loss drugs work, and represent huge value in treating obesity. Even though they are expensive, broader access to them via Medicare would end up saving the U.S. money.
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