[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.