PBMs are essentially volume purchasers of drugs who manage drug benefits for insurers, Medicare, Medicaid, and health plans. PBMs negotiate deals with drug makers, wholesalers, and pharmacies. At least in theory, health plans benefit from the PBM’s buying power. PBMs began innocently enough to buy drugs in bulk at a discount and manage the drug plans for health insurers. Along the way something curious happened. PBMs began to consolidate and drugmakers reported that PBMs began to change their negotiation tactics from bargaining for the best price to instead demanding hefty rebates.
Category: News and Events
Monday Links – 28 September 2026
- In most states, individuals can satisfy Medicaid’s work requirement and maintain coverage by showing $580 in gross gambling winnings once every six months.
- What NPR got wrong.
- What Trump’s trade wars have done to US farmers.
- Traditional Medicare is now using AI to make prior authorization decisions. (Vox)
- Medical myths.
FDA is Shutting Down Importing Cheap Prescription Drugs for Personal Use
I’m only on one (inexpensive) prescription drug I pick up from my local pharmacy, but it would be nice to have options. A Texas woman interviewed by the Wall Street Journal currently pays $10 a week for a Canadian prescription drug that costs 100 times more in the United States. She’s not alone. The Wall Street Journal reports more than two million Americans take prescription drugs they ordered from abroad to save money.