But they do get influence from the pharma companies, and might end up getting kickbacks for it. See the whole Auvi-Q situation, which discounts price to patient

But they do get influence from the pharma companies, and might end up getting kickbacks for it. See the whole Auvi-Q situation, which discounts price to patient to zero, but charges far more than it's sensible to the insurance company: In practice insurance rates go up for everyone, the doctors that prescribe the expensive drug get more money, and the patient's discount make them pick said expensive drug. I've had very serious pushes from doctors to get medication like this.. the doctor was absolutely aware of the economics involved, including what was good for him. I thought I was not at a doctor's office, but dealing with a used car salesman.