Are pharmacy benefit managers driving up drug prices? (Update)

药品福利管理者是否推高了药品价格? (更新)

The Indicator from Planet Money

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2024-09-26

9 分钟
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A group of obscure yet powerful players in the prescription drug industry are under the microscope. On Tuesday, at a Senate hearing in D.C., the head of pharmaceutical giant Novo Nordisk blamed the health insurance industry and pharmacy benefit managers, or PBMs, for allegedly making products like the weight loss drug Ozempic way more expensive in the U.S. than it is in other countries. A few days before that, the Federal Trade Commission sued three of the country's largest PBMs for allegedly using unfair tactics to artificially inflate the price of insulin. So what exactly are PBMs and how do they work? In an episode that aired two years ago, we explain how the answer involves secret deals and double agents. Related episodes: Who can and cannot get weight loss drugs (Apple / Spotify) New drugs. Cheaper drugs. Why not both? (Apple / Spotify) For sponsor-free episodes of The Indicator from Planet Money, subscribe to Planet Money+ via Apple Podcasts or at plus.npr.org. Music by Drop Electric. Find us: TikTok, Instagram, Facebook, Newsletter. Learn more about sponsor message choices: podcastchoices.com/adchoices NPR Privacy Policy
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  • NPR.

  • The CEO of Novo Nordisk, a danish company that makes the weight loss drugs Ozempic and Wegovi, was on Capitol Hill yesterday.

  • A Senate committee questioned Lars Vrogard Jorgensen on why those drugs cost close to $1,000 for a month's supply in the US.

  • That's more than five times higher than the next highest international list price in Japan.

  • Jorgensen blamed the complicated health insurance system in the US, which includes pharmacy benefit managers, aka pbms.

  • We have to negotiate against pbms and their insurance companies not taking much risk and yet benefiting from it for the list price, I think that's absurd.

  • This follows the US Federal Trade Commission filing a lawsuit against three of the country's biggest pbms just last week.

  • CV's, Caremark Express scripts, and Optumrx.

  • The FTC claims these companies engaged in unfair practices that artificially inflated insulin prices.

  • So what the heck are pbms and why do they have so much power in the medicinal marketplace?

  • This is the indicator from Planet money.

  • I'm Darian woods.

  • And I'm Adrian Ma.

  • To answer that question, we're going to share with you an episode we originally ran two years ago.

  • And as you'll hear, the power of pbms involves secret deals and double agents.

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