Will Americans Get PBM Reform in 2024? Maybe, But Many Things Need to Happen In Order to Get There. On the Upside: Insulin Has Opted Out of PBM Sales.

At the core of this post is a YouTube video which can be viewed in the middle of this blog post. The subject is about whether we ' ll get much-needed legislation passed into law to reform corrupt Pharmacy Benefit Managers (PBMs) which we know with absolute certainty were at fault for runaway insulin prices. At least that was true until March 2023, when the three largest insulin manufacturers, starting withLilly, followed byNovo Nordisk and shortly thereafter,Sanofi all announced major insulin list price reductions in the range of 70% to 78%. Think about that for a second: Imagine being able to instantly slash prices by 75% and suffer zero impact to the bottom line? The reason was because we were paying for bribes or kickbacks. Admittedly, they were " legally-exempted " kickbacks, but a bribe is still a bribe and patients were stuck paying for that. Until a few things changed that dynamic.The reason Lilly, Novo Nordisk and Sanofi were all able to cut insulin prices by 75% was by disintermediating the PBMs from insulin sales (in other words, cutting the PBMs out of the transaction), and voila an instant 75% discount can happen with no financial impact for the insulin manufacturers. The losers were the insurance company owned PBMs which had been stealing money the manufacturers paid to PBMs in order to reduce patient insulin prices. Instead, the pharmaceutical industry accomplished massive price-reductions by cutting PBMs including United Healthcare ' s Optum...
Source: Scott's Web Log - Category: Endocrinology Tags: 2024 Congress insulin prices PBM rebates reform Source Type: blogs