Governments Suing Pharmacy Benefit Managers Over Insulin Prices Have Long Benefited From Their Rebates
Governments Suing Pharmacy Benefit Managers Over Insulin Prices Have Long Benefited From Their Rebates
Several state and local governments have filed lawsuits against drug companies and pharmacy benefit managers (PBMs), accusing them of inflating insulin prices.
數個州和地方政府對藥品公司和藥品效益管理者（PBM）提起了訴訟，指控他們操縱胰島素價格。
While these entities claim they're fighting for patients, they've quietly benefitted from the very system they now condemn.
儘管這些機構聲稱他們在爲患者而戰，但他們從現在所譴責的這個系統中暗中受益。
For years, these states and cities have demanded a share of the rebates PBMs secure when negotiating which drugs are covered, profiting from a practice they're now attempting to challenge.
多年來，這些州和城市一直要求從PBM在協商哪些藥品受到保險覆蓋時獲得的回扣中分一杯羹，從中獲利，而現在他們要挑戰此行爲。
PBMs have become powerful gatekeepers in the prescription drug market, dictating which medications are covered and at what cost.
PBM已成爲處方藥市場的強大守門人，決定哪些藥物可以得到保險覆蓋以及其成本。
The same government plaintiffs currently suing have long benefited from these arrangements, the Forbes report notes.
據《福布斯》的報道，目前正在提起訴訟的同一批政府原告長期以來一直從這些安排中獲益。
Drug makers and patients, meanwhile, bear the brunt of this dysfunctional system. The lawsuits primarily argue that insulin prices are unreasonably high and blame drug companies and PBMs.
而藥品製造商和患者則是這個功能失調系統的受害者。這些訴訟主要是聲稱胰島素價格過高，指責藥品公司和PBM。
However, this argument doesn't hold up under scrutiny, as insulin prices have been steadily declining. For instance, Eli Lilly And Co (NYSE:LLY) reported that the net price for its Humalog insulin dropped from $62 per vial in 2018 to $26 in 2023, with its biosimilar Lispro costing just $17 per vial last year.
然而，這個觀點經不起審視，因爲胰島素價格一直在穩步下降。例如，禮來（Eli Lilly And Co）報道稱，其赫樂格胰島素的淨價從2018年的每支62美元降至2023年的每支26美元，而其生物類似藥利普洛則僅售每支17美元。
Last year, Sanofi SA (NASDAQ:SNY) and Novo Nordisk A/S (NYSE:NVO) slashed the prices of their insulin products.
去年，賽諾菲安萬特（Sanofi SA）和諾和諾德（Novo Nordisk A/S）大幅降低了他們的胰島素產品價格。
The report further noted that the more credible accusation in these lawsuits is that PBMs drive up patient costs by demanding rebates and fees from pharmaceutical companies. These payments are tied to a drug's list price, incentivizing PBMs to favor higher-priced medications, where more significant rebates can be negotiated. Unfortunately, these savings don't reach patients; instead, PBMs and the health plans that hire them pocket the rebates.
報告進一步指出，在這些訴訟中，更可信的指控是，PBM通過向藥品公司要求回扣和費用來增加患者的費用。這些付款與藥品的標價掛鉤，激勵PBM傾向於更昂貴的藥物，因爲可以談判更大的回扣。不幸的是，這些節省並沒有惠及患者；相反，PBM和僱傭它們的健康計劃將回扣裝入口袋。
Ironically, several of the states and local governments now suing PBMs insisted that their PBMs pass along rebates for drugs taken by their beneficiaries.
具有諷刺意味的是，現在起訴PBM的幾個州和地方政府堅持要求他們的PBM將受益人使用的藥物的回扣傳遞下去。
Yet, these health plans chose not to share those savings, highlighting their complicity in the problem. Between 2017 and 2019, PBM profits grew by 12%, reaching $28 billion, the report highlighted. Today, rebates and fees account for 42% of every dollar spent on brand-name drugs, totaling $72 billion in 2022.
然而，這些健康計劃選擇不分享這些節省，突顯了他們在問題中的串通。報告強調，2017年至2019年間，PBM的利潤增長了12%，達到了280億美元。如今，回扣和費用佔每一美元在品牌藥物上花費的42%，2022年總額達到720億美元。
Patients remain sidelined in this scheme, as their cost-sharing is based on the list price, not the discounted rate.
患者在這種計劃中仍然被邊緣化，因爲他們的費用分擔基於標價，而非折扣率。
Consequently, PBMs and the health plans that employ them profit twice: from substantial rebates collected from drug makers and artificially inflated copays imposed on patients.
因此，PBM和僱傭它們的健康計劃從藥品生產商收取的大量回扣以及對患者強加的人爲增加的藥費中獲利兩次。
Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.
免責聲明：本內容部分使用人工智能工具生成，並經Benzinga編輯審核發佈。
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譯文內容由第三人軟體翻譯。