Pharmacy benefit managers keep less than 1% percent of rebates for Medicare Part D drugs, GAO says

Healthcare Finance News August 14, 2019
Susan Morse

Part D plan sponsors mainly used five PBMs in 2016: CVS Caremark, OptumRx, Express Scripts, Medimpact and Argus.

A recent Government Accountability Office report on Part D drug expenditures and the revenue received by pharmacy benefit managers shows that while PBMs and plan sponsors are successful in helping to lower some prescription prices, more needs to be done to bring down costs, said House Ways & Means Committee Chairman Richard E. Neal.

Medicare Part D plan sponsors used pharmacy benefit managers to provide 74 percent of drug benefit management services and performed the remaining 26 percent of services themselves in 2016 — the most recent year data was available, according to the report.

Part D plan sponsors mainly used five...

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