Express Scripts’ Lawsuit Reveals Striking Information About PBM Rebates
For years, PBMs have consistently refused to disclose any information about their secret “deals” with manufacturers to obtain “rebates” – that PBMs presumably pass through – and “other monies” – that PBMs collect from manufacturers but PBMs may retain for themselves.
But now, a new lawsuit filed by Express Scripts against the drug manufacturer kaleo reveals at least some information about Express Scripts secret deals. And the information is shocking. Express Scripts is clearly collecting mega-millions of dollars from manufacturers, and much of that money is labeled “administrative fees” and “price protection rebates” that Express Scripts may not be entirely passing through to its clients or the federal government. Every Plan administrator and fiduciary – and the federal government – should insist on learning more about the millions that Express Scripts and other PBMs are collecting.
Read More
Message from Mylan: Pay Attention to Rebates
In recent testimony before a House Committee, Mylan’s CEO asserted that $334 of EpiPen’s list price of $608 – or 55% of the total $608 – could be attributed to PBMs and three other drug channel vendors extracting payments from Mylan.
Soon, other evidence emerged reflecting manufacturers’ price increases related to diabetes and rheumatoid arthritis drugs might be related to PBMs’ rebate activities. These new developments make clear that every Plan administrator needs to understand the complex world of drug manufacturer rebates and other payments, and develop strategies that will address these issues.
Read More