Hapless Plan Sponsors Are Screwed By Switch Operators

A ‘Switch Operator’ is a Software Clearinghouse Between a Pharmacy and a PBM that Allows the Pharmacy to Check the Patient’s Drug Formulary, Copay and other Insurance Information.

McKesson’s RelayHealth and Change Healthcare Are the Two Companies That Dominate the Switch Operator Market.
Switch Operators ‘Sell’ the Right to Automatically Insert Prescription Coupons at the Point-of-Sale at the Pharmacy to Pharmaceutical Manufacturers.
These Automatic Coupons Allow Drug Companies to Get Around the Employer Health Insurance Plan Design Copay, Co-Insurance and Deductible and Lower the Out-of-Pocket Cost for the Patient.
As a Result, Patients are More Likely to Stay on Expensive Brand Name Medications Than Change to Less Expensive Generic Medications Because of the ‘Artificially’ Low Out-of-Pocket Cost Manipulated by the Drug Company. Sources:

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