Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
How can a pharmacy buy the insurance company that pays them for their services as currently proposed i.e. CVS buying Aetna? PBMs have entirely too much power, they make the contracts and unless you are a major player you simply cannot negotiate. They make all of the rules, in many cases they tell a pharmacy what they will pay for a prescription then months later take some of that money back. As a small pharmacy we have zero knowledge of what or how much or even what prescriptions they will take money back from. In some cases they tell us what to charge a patient and then later take money back from us, makes the patient look like they are paying a lot, the pharmacy is getting paid yet in fact the pbm is stealing all the money back. In many cases they don't even cover the pharmacies cost of medication much less any service.