re: The three largest PBM’s
If these companies are as useless to their clients as you suggest, the PBM industry ranks as one the largest corporate scams of all time.
I know I'm going to sound like a nut, but basically, I agree with your conclusion. The PBM is nothing but a middleman, changing money from one group to another, taking a large cut, and providing little to no verifiable benefit. They are experts in hiding what they actually do, and,in general, Benefit Coordinators are not trained to understand the true costs associated with pharmacy benefits. In my meetings, the Coordinators were not aware that PBM's use multiple AWPs when paying pharmacies and billing sponsors. They don't know that the PBM pays the pharmacy a different rate than they are billed. This spread is usually 2-4%. They definitely don't understand that PBM's keep more of the rebates than they give out. Please feel free to google lawsuits and any PBM to see many of the settlements regarding these issues.
Basically, businesses are ill equipped to manage these costs so PBMs fill this need. From an investors perspective, PBMs make money. From a global perspective, just because PBMs make money doesn't mean they are effective at lowering costs.
I really am not a communist. I like profit in business. I beleive there would be more profit in all businesses if there were less middlemen in healthcare.
RPh
I'll respond more later if I can
