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In Oklahoma, CVS’s P.B.M., Caremark, charged the health plan for state employees $138,000 a year for a generic version of the cancer drug everolimus. Yet the same drugs was available from wholesalers for about $14.000.
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In New Jersey, Cigna’s P.B.M., Express Scripts charged a 77-year-old retiree $211 for a three-month supply of his allergy drug, when the same drug was available at Costco for $22.
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In California, CVS Caremark charged Blue Shield $3,000 a month for the cancer drug abiraterone acetate. For the same drug, Express Scripts charged Hyatt $1,500. It is available from wholesalers for $150.
This is a very good piece of investigative reporting. However, it missises the real story, which is explained in this piece at our website. People who need expensive drugs are being overcharged so that drug insurance premiums can be artificially lowered for everyone – including all the people who don’t need those drugs. In this way, the sick are subsidizing the healthy. Employers (and insurers generally) have a perverse incentive to attract the healthy and avoid the sick. They are not allowed to do that directly. So, they do it indirectly.