RE: are the three big national PBM’s different
This is truly my opinion so please don't take this as God's Law.
I feel the PBM concept as a whole is flawed. The Big 3 do offer some plans a "pass-thru" or transparent contract. These contracts state that the sponsor will get all discounts and rebates and will pay a transaction fee for service per claim. The problem is that the sponsor has no way to audit for these discounts and rebates. Sponsors have no rights to see exactly what rebates have been paid to the PBM. Until the laws are changed to allow for true transparency, I wouldn't be able to say that the concept would be acceptable.
As you can see, I'm full of opinions and short on universally usable solutions. My question to you is:
Which came first, the high cost of medicine or the insurance companies that insulated all of us from seeing the escalating cost of medicines?"
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