AJMC January 17, 2025
Key Takeaways
- Insurer-PBM firms dominate the Medicare Part D market, steering patients to their pharmacies, raising regulatory concerns about competition and patient choice.
- The study analyzed Medicare Part D claims data, revealing significant use of insurer-PBM-owned pharmacies and evidence of steering.
- Findings highlight the need for market-specific insights to guide regulation and further research on insurer-PBM and pharmacy integration.
- Despite limitations, the study underscores the importance of understanding the implications of insurer-PBM and pharmacy integration.
Insurer-pharmacy benefit manager (PBM) firms control most of the Medicare Part D market, steering patients to their pharmacies through network exclusions and targeted marketing.
Insurer–pharmacy benefit manager (PBM) firms make up a significant share of the Medicare Part D market and steer patients...
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