Pharmacy Benefit Manager Pricing and Spread Pricing for High-Utilization Generic Drugs

Author:

Mattingly T. Joseph1,Ben-Umeh Kenechukwu C.1,Bai Ge23,Anderson Gerard F.3

Affiliation:

1. Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City

2. Johns Hopkins Carey Business School, Baltimore, Maryland

3. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

Abstract

This cross-sectional study uses Medicare Part D claims for high-utilization generic drugs to analyze gross profits accumulated by pharmacy benefit managers, pharmacies, wholesalers, and manufacturers in the pharmaceutical supply chain.

Publisher

American Medical Association (AMA)

Subject

Public Health, Environmental and Occupational Health,Health Policy

Reference6 articles.

1. State-level policy efforts to regulate pharmacy benefit managers (PBMs).;Mattingly;Res Social Adm Pharm,2022

2. The impact of alternative pricing methods for drugs in California workers’ compensation system: fee-schedule pricing.;Wilson;PLoS One,2018

3. Pharmacy Benefit Manager Transparency Act of 2023, S 127, 118th Cong (2023). Accessed February 27, 2023. https://www.congress.gov/bill/118th-congress/senate-bill/127?q=%7B%22search%22%3A%5B%22S.+127%22%5D%7D&s=1&r=4

4. Pharmacy Benefit Manager Reform Act, S 1339, 118th Cong (2023). Accessed May 3, 2023. https://www.congress.gov/bill/118th-congress/senate-bill/1339?q=%7B%22search%22%3A%5B%22Pharmacy+Benefit+Manager+Reform+Act%22%5D%7D&s=1&r=1

5. Medicare Part D spending by drug. Centers for Medicare & Medicaid Services. Accessed April 25, 2023. https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug

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