Watchdog: Insurance Groups Buy Drug “Middle Men”; Transparency Calls Grow

Spectrum News 13

July 23, 2019

PBMs: have you heard of them? If not, you’re not alone, but they do factor into your prescription drug costs.

They’re essentially a “middle man” between drug makers, health care plans, and patients, negotiating the prices most of us pay for prescription drugs.

n the last two years, health insurance companies, which set deductibles and co-pays, have bought up the three main PBMs: Express Scripts, CVS Caremark, and Optum RX.

A number of independent pharmacies have told Spectrum News they are now losing business and revenue because of PBMs, including Five Points Pharmacy in Cocoa, a pharmacy that has been welcoming customers since 1958.

Louella McCormick Edwards started coming to 5 Points Pharmacy with her mother. But now, Edwards says most of her family can no longer get their medication filled at 5 Points after their health plans dropped the pharmacy from their networks.  Continue Reading

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