Turning PBM " Arbitrage " On Its Head: Bypassing Insurance to Save

The word of the day is " arbitrage " . Officially, Merriam-Webster defines the English language word " arbitrage " this way: " The nearly simultaneous purchase and sale of securities or foreign exchange in different markets in order to profit from price discrepancies " . However, arbitrage does not exclusively apply to securities sold on Wall Street. The term has also been adopted by the Pharmacy Benefit Manager ( " PBM " ) industry. But PBM ' s are not Wall Street investment banks. And that ' s something we all need to realize.The PBM Accountability Project 2021 report " Understanding the Evolving Business Models and Revenue of Pharmacy Benefit Managers " (download their highly informative report by visitingHERE) defined the term " arbitrage " this way:" PBMs ' lack of transparency is critical to their operations and allows them to buy a product (or service) [such as a drug or biologic medicine] from one stakeholder in the system and re-sell that product (or service) to another stakeholder at a significantly higher price, all without the payer understanding the true cost or inflationary nature of the services they have just purchased — a practice [euphemistically] referred to [by the PBM industry] as ' arbitrage ' " .Adam Fein, President of Pembroke Consulting and another entity he calls The Drug Channels Institute described the situation this way when he observed how a surprising majority (75%) of GoodRx customers actually have a drug benefit provided by insuran...
Source: Scott's Web Log - Category: Endocrinology Tags: 2022 arbitrage coupon-generating websites apps coupons Medicare PBM Source Type: blogs