KevinMD December 20, 2025
As elected officials and citizens brace for the possible expiration of federal subsidies for health insurance premiums, many wonder if there are alternatives to the confusing rebate/copay/deductible/premium drug coverage word salad (see: PSAOs, GPOs, NADACs, ASOs, MLRs, AWPs, WACs, U&Cs, MACs, BERs, GERs, DFERs, GDRs, NDCs, DIRs, and ERISAs).
Just because patients don’t understand the opaque layers/players behind the drug procurement affordability crisis, doesn’t mean that lawmakers do, say experts (which is part of the problem).
The bigger problem, though, is that “Big Pharma” (increasingly “BioPharma”) is a silent funder of two-thirds of Congress members, 57 percent of U.S. doctors, hospitals, medical schools, and medical practices, and notably almost all news outlets thanks to “ask your doctor” ads. (See: “Chronic”...
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