“A Growing Profit Center for Vertically Integrated Pharmacy Benefit Managers”
“The Big 3 PBMs’ affiliated pharmacies generated significant and growing levels of revenue in excess of estimated acquisition cost (NADAC) on the most highly marked up specialty generic drugs…………… the Big 3 PBMs also appeared to take in significant income from spread pricing………….plan sponsors in particular should be aware that they and their members are paying the Big 3 PBMs and their affiliated pharmacies very significant markups over the acquisition costs for critical medications.”
“Prescription drugs represent a large and growing amount of healthcare spending—increasing from $393 billion in 2016 to $600 billion in 2023.1 While traditional drugs dispensed through retail and mail order pharmacies account for much of this spending, a disproportionate share of the growth has come from spending on a class of drugs known as specialty drugs, which more than doubled from $113 billion in 2016 to $237 billion in 2023.2 Historically, specialty drugs were characterized by their need for special handling and administration. This is no longer
necessarily the case. There is no standard definition for a specialty drug, and today specialty drugs may be characterized by variety of factors, including their high cost.”
See full report HERE
