3 ms·

> In theory, competition among PBMs for the business of payers like the jail mentioned in the article would drive lower costs for payers. I noticed that all of

• shimon 8y ago
  The key examples of massive spread chosen for this article are all in novel generics. These drugs are going to have massive price volatility because multiple generic vendors are entering the market at the same time, and they're flowing through various distributors to pharmacies that have varying inventory of the drugs. So of course the spread is significant, and it's likely that both pharmacies and PBMs are pocketing higher margins on these products between the time that generics initially become available and the time that suppliers and prices stabilize. Seems plausible that if you looked at non-PBM pricing for these drugs over the same period you might find that the PBMs do in fact reduce volatility and accelerate price stabilization, i.e. they are doing their jobs. Or maybe they're not. But the fact that underlying price volatility implies higher spread seems like something you'd just expect with a PBM model.