Uncovering the group driving up the cost of medication

Video- When you go to the pharmacy, chances are you expect you are getting a fair price for your medication, especially if insurance is involved. But some local pharmacists want you to know that may not always be the case. They said they are part of an equation that can include some dishonest middlemen, not always, but some of the time.

The traditionally insured prescription world relies on something called the pharmacy benefit manager or PBM.

“A pharmacy benefit manager is the middleman between the insurance company and the pharmacy,” Antonio Ciaccia from the Ohio Pharmacists Association said.

According to Ciaccia, the three biggest middlemen in the business, Express Scripts, CVS Caremark and Optum Rx, represent more than 70 percent of the patients in the U.S. marketplace.

“They are able to use those patient lives to their advantage to negotiate better pricing on drugs or lower reimbursements to pharmacies because of the bodies they represent,” Ciaccia said.

But some pharmacy owners say not all patients are seeing that better pricing. They did not want to share their names because they say they signed contracts to work with the PBMs’ patients and those contracts have rules….

Read the full story or watch the video here

Kristyn Hartman