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PBMs: Friends or Foes?

Healthcare Unfiltered

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The Advantages of PBMs in Prescription Drug Coverage

The PBM is this intermediary entity that decides on the coverage of prescription drugs technically. This allows them to get enormous discounts and rebates for the drugs that they're negotiating. And because the market is so highly concentrated among these top three PBM's, you would imagine that they could get really huge discounts by saying, "If you're willing to make a deal with me, you have access to 30% of claims that get processed in the US market"

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