Medical Economics December 6, 2023
Richard Payerchin

‘The results are alarming,’ with potential financial effects for patients and pharmacies, researchers say.

Medicare Part D patients are overpaying for generic drugs with “alarming” results as health insurers artificially inflate prices.

A new study found private health insurers that sponsor Medicare Part D prescription drug plans use pharmacy benefit managers (PBMs) that inflate drug costs by overpaying pharmacies for the medicines. Those reimbursement practices in turn affect patients by using those higher prices to calculate copays and deductibles, according to the research letter published in JAMA.

“By inflating the amount paid to pharmacies, PBMs make patients pay more because patient cost sharing is based on point-of-sale reimbursement,” the study said.

“The results are alarming,” corresponding author Inmaculada Hernandez, PharmD,...

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