My understanding is that it's both of them. - Lilly wants to set the price at, to pick a random number, $100 per bottle. - PBM says "I need to tell the insura

My understanding is that it's both of them. - Lilly wants to set the price at, to pick a random number, $100 per bottle. - PBM says "I need to tell the insurance company I saved them 50%, so you have to charge _my_ client 50% of list price" - Lilly wants their business, so changes the list price to $200. - Then Lilly "graciously" lets people without insurance use a coupon to _only_ pay $100 for it. Everybody gets to pretend they're the good guy. But the insulin costs $5 to make.. so really, they're not (once again, made up numbers).