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As the debate over prescription drug costs intensifies, Kentucky officials have released a report showing pharmacy benefit managers kept a widening share of money collected on behalf of the state Medicaid program, and they recommend several steps for overhauling relationships with these controversial pharmaceutical middlemen.

Specifically, PBMs appear to have profited from what is known as spread pricing, which refers to the fees these companies pay pharmacies and then bill back to state Medicaid programs. Last year, PBMs were paid $858 million, of which they kept $123.5 million, or 13 percent. This was up from 9.4 percent in 2017, according to the report by the Kentucky Cabinet for Health and Family Services.

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  • You know what I just can’t figure out . The PBM’s have been found over paying
    themselves hundreds of millions of dollars from how many states ? 5 ? 10?
    They have been caught over and over again, yet no one will go to jail for this crime. Can someone please tell me why ??????

  • Ed , How many times must I say the same thing ? It’s the spread that their stealing ! If there was no AWP pricing
    then there would be no spread ! Can you imagine the nerve of a CVS spokeswoman argued that, “to the extent there is any (spread) in a PBM contract (it) is not a PBM’s profit. It is used to fund benefit services . Ha !!! What a bunch of CRAP !!!! I have a bridge I want to sell to this CVS spokeswoman !!!!!!
    Express Scripts shovels more B.S. !!!! Can you fathom they have the Balls to say,” Spread pricing arrangements provide predictability, competitive rates, and deliver value for our clients.”
    What provides predictability is net cost pricing plus a professional fee, and the PBM gets a transaction fee !
    I guess they can say anything and try to get away with it !!!! What a bunch of horse dong !!!!!!

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