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The simple corporate scheme behind massive US Brand Drug Prices

My 7-year whistleblower effort
"People Before Profits"

Dark Secret: PBM Profits

PBM Brand Drug Profits have come almost entirely from Pharma Companies for the Past 20 Years

BEFORE Medicare Part D:

  • PBM profits came from secretly keeping MOST “pharma rebates”, instead of passing them on to patients and clients
    • In 2003, the largest PBM, Medco (now part of Cigna/Express Scripts) kept more than half of "manufacturer brand drug rebates"
    • For 2003, the brand drug "manufacturer rebates" Medco kept accounted for MORE THAN 100% of the the company's entire corporate profits

AFTER Medicare Part D:

  • PBM brand drug profits have secretly come mostly from "pharma fees" tied to "sticker" prices and price increases
  • The pharma/health insurer/PBM "partners" secretly switched from "rebates to “pharma fees” because:
      • PART D required full rebate transparency for the first time
      • Widespread pharma U.S. patent losses led to fewer U.S. brand drugs and less rebate opportunities
      • Limited Part D "pharma fee" (i.e., bonafide service fee (BFSF)) reporting and oversight
        • Enabled unlimited "pharma fee" payment to health insurer/PBMs tied to massive U.S. brand drug prices and price increases
  • “PHARMA FEES” NOW SECRETLY ACCOUNT FOR 80-100% OF HEALTH INSURER/PBM PROFITS FROM U.S. BRAND DRUGS AND LIKELY MOST OF PBM OVERALL PROFITS 
  • NOW NEARLY 15 YEARS SINCE IT BEGAN, THIS SIMPLE, BUT SECRETIVE, PHARMA/HEALTH INSURER/PBM COLLUSIVE PARTNERSHIP HAS CAUSED UNPRECEDENTED PATIENT AND PUBLIC HARM

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