[pkaye]

The drug companies are trying to price differentiate. They want to charge the insurance company a lot more but not make the end user feel the pinch of the copay that makes them consider alternatives. Its kind of like on business trips, people spend a lot more than they usually do because its not their money.

Being in dialysis, I take a bunch of medicines. One was very expensive buy the drug company put lots of effort to make sure I got the copay reimbursed. Again they were after the insurance money and were willing to reimburse 10% of an inflated cost. After the patent expired and generics were available, my copay went down by 90%.

[s1artibartfast]

It is more complicated than that. Pharma companies dont get paid by insurance companies. They must go through federally mandated pharmacy benefit managers. The benefit managers keep the rebate, but charge list prices, so they have an incentive to drive up both

[pkaye]

In my own experience I got a drug company to directly reimburse me the copay. They didn't care about the middle man, just proof that it was their medicine.

[s1artibartfast]

But you nor your hospital paid the pharma company, they paid the PBM

[pkaye]

I don't know how the money is divided but I do know the drug manufacturer (I think mine was Pfizer) seemed all too happy to reimburse my copay up to $6000/year. I get a feeling they make a substantial amount of profit.