[refurb]

Huh? If a company gives you a $5 rebate for buying 5 bottles of shampoo, then it gets extra sales.

So if a $5 grocery rebate a kick-back?

[Dylan16807]

Increased sales, when paid by the same entity that gets the rebate, are not a kickback.

If a doctor took money to steer you to a specific hospital, that would be a kickback.

If a hospital gives you a rebate and you're paying, that's not a kickback. But if a hospital gives you a rebate and your insurance is paying based on the non-rebated price, that's probably a kickback.

[refurb]

Precisely. PBM rebates are based on sales as well. Drug company gets more sales by making their drug “preferred” and PBM gets a rebate. It’s not a kickback.

[Dylan16807]

Precisely what? If the PBM gets money then that's not the customer. Being paid for marking something as preferred is a kickback.

If the PBM buys something themselves and gets money back, that wouldn't be a kickback.

Just like a customer buying something and getting money back.

But when you have a buyer on one side, and a separate entity getting the money back, that's probably a kickback.