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TPM Reader JB delves into the nuts and bolts of health care economics and responds to TPM Reader LS …
I think LS is appropriately angry, but he/she is misdirecting that anger. No, I’m not a fan of insurance companies. Insurance companies don’t really select what to cover and not to cover. They farm that work out to Pharmacy Benefit Managers (PBMs). PBMs administer the prescription drug plans for more than 250 million Americans. They act as intermediaries between pharmaceutical companies, insurance plans, and patients. They do this work for commercial plans, Medicare Part D plans, and state and Federal Health plans. Three companies (Express Scripts, OptumRx, and CVS Health) control nearly 80% of the market.
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