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For many Americans, the rising tide of prescription drug prices feels like a relentless force, threatening to drown household budgets and healthcare access. While pharmaceutical companies often take the brunt of public blame, the web of influences on drug costs is far more intricate. Today, we train our spotlight on a critical, yet typically shrouded, player in this system: pharmacy benefit managers, or PBMs.
Rebecca Robbins, a leading investigative journalist specializing in pharmaceuticals for the New York Times, will take us on a deep dive into the world of PBMs. We’ll explore their role as intermediaries between drug manufacturers, insurers, pharmacies, and ultimately, patients. This complex dance can have a significant impact on how much you pay for your medications.
Our investigation will delve into how PBMs negotiate drug prices, formulate coverage lists (which dictate which medications are covered by insurance), and manage pharmacy networks. We’ll also explore the potential conflicts of interest that can arise within this system, and how these practices might be contributing to the rising cost of prescription drugs.
By understanding the role of PBMs, we can gain a more comprehensive picture of the factors driving drug affordability. This knowledge is crucial as policymakers and healthcare stakeholders work towards creating a more sustainable and equitable prescription drug market for all Americans.
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