Florida finds pharmacy benefit managers are benefiting from a lucrative profit center

Stat News

As states struggle to control the cost of prescription medicines, a new report found pharmacy benefit managers pocketed more than $89 million collected on behalf of the Florida Medicaid program — and the consultants who ran the analysis recommended state officials rework the arrangements.

The report found that PBMs appear to have profited from what is known as spread pricing, which refers to the dispensing fees that these companies pay pharmacies but then bill at a different rate to state Medicaid programs. In this instance, the PBMs working with managed care plans made $8.64 for each Medicaid prescription, which accounted for 9.5% of total plan spending.  Continue Reading

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