CBS Boston: Patients Rising advocate exposes PBM price gouging
Are you being charged more for your medicine BECAUSE you have health insurance?
Patients Rising advocate Amy Frostland recently told her story to CBS Boston’s award-winning investigative journalist Ryan Kath.
“If I run my insurance, it’s going to cost me $90 for a three month supply; if I do it without insurance, it is $10 for a three month supply,” she explained. “Health insurance is ridiculous.”
Kath’s investigation reveals that the primary cause of this price gouging lies with a drug middleman, known as a pharmacy benefit manager.
“Pharmacy benefit managers, or PMBs… act as middlemen between insurance companies and pharmacists to process your prescriptions. They negotiate prices with drug manufacturers and they handle all the patient claims.”
Pharmacists Barred from Helping Patients Save Money
CBS Boston’s investigation uncovered one of the most scandalous policies in health care. Pharmacists can’t tell patients that they’re being overcharged.
“Pharmacies are prohibited from talking to patients about how much a patient would pay if they just pay cash and didn’t go through their insurance,” Todd Brown of the Massachusetts Association of Independent Pharmacists told CBS Boston.
“When you look at the profit these companies make, it’s excessive. It’s inconsistent with the rest of the health care industry,” he adds.
Check out Award-Winning Journalist Ryan Kath’s Investigation at CBS Boston.