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How pharmacies, drug makers, PBMs and health plans are benefiting from your Rx benefits!

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It is easy to point fingers at rising drug prices, it is much harder to point at the drivers of that growth. To understand drug prices, one needs to understand how the drug value chain works, from the drug manufacturer to the patient. This value chain is an incredibly complex flow with many parties involved. Here is my take on explaining how the reimbursement of drugs work and who is making money along the way. There is a lot of nuance to this topic and will have to leave out quite a bit of detail here. To set some focus, I will only look at brand drugs that are distributed via a retail pharmacy. This is the bulk of the $500bn drug sales in the US every year. But there are also other value chains worth looking at, such as generic drugs & physician-administered drugs (for example like many cancer medications). However, they deserve a dedicated analysis, as the margin captured by the different players differs quite a lot. Let's get started and let us first have a look at this overview ch

How pharmacies, drug makers, PBMs and health plans are benefiting from your Rx benefits! A closer look at branded drug reimbursements and drug prices. Nov 28, 2021 2 2 Share It is easy to point fingers at rising drug prices, it is much harder to point at the drivers of that growth. To understand drug prices, one needs to understand how the drug value chain works, from the drug manufacturer to the patient. This value chain is an incredibly complex flow with many parties involved. Here is my take on explaining how the reimbursement of drugs work and who is making money along the way. There is a

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