[zaroth]

Two different things entirely. The fake “Discount off MSRP” demanded by the PBM has nothing to do with the profit margin of the PBM, that would be based on markup they charge to their customers above the price they actually pay.

But the regular uninsured consumer sure gets screwed.

I think this is why there are now self-pay “codes” you can give a pharmacy to get a significant discount off retail price. Sometimes less than your co-pay, but of course then it doesn’t count toward your deductible.

I wish they would simply ban these pricing gimmicks as part of a price transparency law.

There should be one price and one price only the manufacturer can charge in the USA per dose of an FDA approved medicine, with no ability to do price differentiation, period. No more negotiating, no more kickbacks. Insurance should have to show you the actual price they paid, and no other. And then you pay the patient responsibility of the bill based on your standard policy formula.

The same pricing transparency should be applied to labs and procedures where it should be illegal for a given facility to charge two different patients two different prices for the same product or service.

[tsjq]

i cannot agree more with this .