Consumers focus on price and accessibility of drugs. Even quality may only 'place' third. To catch more attention, can you refer to studies or your own research which explains how much costs will increase and accessibility decrease with vertical integration?
Hi Ralph, thanks for the comments and my apologies for the long delay in responding. So on the question of costs. The National Community Pharmacy Association points to a study that found PBM rebates to drug manufacturers raise costs by nearly 30% (https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/medicine-spending-and-affordability-in-the-us) and the power PBMs have is in part because of the vertical integration these companies have where they will own insurers, PBMs and in some cases pharmacies.
To your question about access, the rapid decline of independent pharmacies is one example of how they reduce access and I would also note that what the PBMs seem particularly interested in long-term is steering everyone to their mail-order pharmacies, which I imagine is one reason they don't mind decimating the locals.
Not PBM related, but increased costs and reduced access are consequences of the consolidation across healthcare. I'm most familiar with hospitals as the MN legislature has been working to address that issue recently. Increased costs are a well known consequence of hospital consolidation that a wide range of studies have born out. Access also becomes an issue though because hospital systems will gut local hospitals, whether by outright closure or reduction of services, to steer patients to a flagship location. The Commonwealth Fund is a good resource (https://www.commonwealthfund.org/consolidation) and Kaiser has good stuff as well (https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/). If you really want to dig in, Big Med is an interesting book on the issue, although at least for me was a little too wonky for a non-healthcare expert (https://press.uchicago.edu/ucp/books/book/chicago/B/bo44654714.html).
Hope that helps! And thanks again for reading and for the questions!
Thank you very much Justin for your thoughtful response. Thank you -also-for your work. Unfortunately, when I talk about corporate power or vertical integration, peoples eyes gloss over. People complain about drug prices; when asked about big ag for example or big Pharma, people say they don’t like it. And the same people disagree with my arguments for government regulation of big Pharma, big ag, etc., as I know note because the marketplace doesn’t work. That’s why columns in social media or traditional media or even letters to the editor are helpful to help bridge caps, in understanding
My wife would disagree with your assessment lol, but thank you for the support and for reading, or in this case watching! Really appreciate it. Break 'em up!
Consumers focus on price and accessibility of drugs. Even quality may only 'place' third. To catch more attention, can you refer to studies or your own research which explains how much costs will increase and accessibility decrease with vertical integration?
Hi Ralph, thanks for the comments and my apologies for the long delay in responding. So on the question of costs. The National Community Pharmacy Association points to a study that found PBM rebates to drug manufacturers raise costs by nearly 30% (https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/medicine-spending-and-affordability-in-the-us) and the power PBMs have is in part because of the vertical integration these companies have where they will own insurers, PBMs and in some cases pharmacies.
To your question about access, the rapid decline of independent pharmacies is one example of how they reduce access and I would also note that what the PBMs seem particularly interested in long-term is steering everyone to their mail-order pharmacies, which I imagine is one reason they don't mind decimating the locals.
Not PBM related, but increased costs and reduced access are consequences of the consolidation across healthcare. I'm most familiar with hospitals as the MN legislature has been working to address that issue recently. Increased costs are a well known consequence of hospital consolidation that a wide range of studies have born out. Access also becomes an issue though because hospital systems will gut local hospitals, whether by outright closure or reduction of services, to steer patients to a flagship location. The Commonwealth Fund is a good resource (https://www.commonwealthfund.org/consolidation) and Kaiser has good stuff as well (https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/). If you really want to dig in, Big Med is an interesting book on the issue, although at least for me was a little too wonky for a non-healthcare expert (https://press.uchicago.edu/ucp/books/book/chicago/B/bo44654714.html).
Hope that helps! And thanks again for reading and for the questions!
Thank you very much Justin for your thoughtful response. Thank you -also-for your work. Unfortunately, when I talk about corporate power or vertical integration, peoples eyes gloss over. People complain about drug prices; when asked about big ag for example or big Pharma, people say they don’t like it. And the same people disagree with my arguments for government regulation of big Pharma, big ag, etc., as I know note because the marketplace doesn’t work. That’s why columns in social media or traditional media or even letters to the editor are helpful to help bridge caps, in understanding
Everything you say is true!
Break 'em up!
My wife would disagree with your assessment lol, but thank you for the support and for reading, or in this case watching! Really appreciate it. Break 'em up!