3 ms·
I've been hit by this too. The scam is really simple: Take the example in the article: Shire normally sells Adderall for $200. They offer to sell it to UHC for
by xenadu02 9y ago
I've been hit by this too. The scam is really simple:
Take the example in the article: Shire normally sells Adderall for $200. They offer to sell it to UHC for $50. The generic costs UHC $60. UHC takes the generic off the formulary and will only pay for Shire.
For the end user the out-of-pocket cost goes from $10-20 to $50 because brand medications are in the "Premium" category.
By saving $10 UHC sticks you with a $40 higher bill - literally 4x what they are saving.
Targeting this specific behavior is trivially easy: change the law to require insurers to cover generic or brand for any RX at the patient's choice.
- phkahler 9y agoBetter yet, from the article: Then, a few years ago, Shire tried a new tactic: giving ever-larger discounts to pharmacy benefit managers and insurers for preferential treatment over the generics. That did not mean lowering the list price of the drug, but rather negotiating rebates that were paid not to the patients but to insurers and middlemen such as CVS Caremark. Just prosecute them for anti-competitive practice or even collusion. What they are doing is probably already illegal.