Recent price increases on the lifesaving allergy drug EpiPen have spawned a conversation about how drug pricing works in this country. Unfortunately the focus on this one product by a one-note media and headline chasing polls has obscured a far bigger issue — the corrosive role of Pharmacy Benefit Managers (PBMs) who oversee drug prescription plans in driving up consumer prices.
Mylan, the manufacturer of EpiPen, for example, receives less than half the list price for an EpiPen 2-Pak. PBMs — who do not research, develop, create or manufacture any new treatments or drugs generally claim 40 to 50 percent of a medicine’s list price via an obscure and complex system of mandatory rebates — not to be confused with “kickbacks,” “collusion’ or other recognized improprieties.
On a $600 EpiPen, the PBM is likely receiving close to $300 on each prescription.
The Hill. By David Balto, contributor