I think nowadays more people watch youtube than printed news, so its pretty fine here.
@SharkLightning
5 жыл бұрын
The one thing left out we're DIR fees, or as we call them, claw backs. Several months after we dispense a med to a patient, the PBM can decide they paid us too much and take away the little bit they already paid the pharmacy. In the process, pharmacies have to continue to cut back on labor due to ever shrinking profits, but PBM's still continue to have record profits quarter over quarter.
@trendthis364
5 жыл бұрын
Killed the PBMs
@Subvisual
5 жыл бұрын
I think you're using the term clawback incorrectly here. True clawbacks are a different and even more mind-numbingly evil thing. Say my pharmacy wants to charge you $10 for your prescription. Alas you have clawback drug plan, which you foolishly request we bill. Your PBM receives our payment claim, and for some insane reason requests that we make you pay a $15 copay, and then reimburse the PBM the $5 difference. A clawback PBM claim literally has the pharmacy charge the patient more than the usual cash price purely so the PBM can profit off the handling fee.
@Terrafire123
Ай бұрын
The information PBMs are using to decide whether they gave pharmacies too much money is proprietary, isn't it? What's stopping them from charging DIR fees on EVERY transaction?
@johnl.7754
5 жыл бұрын
People without insurance gets screwed over the most in US medical system.
@dennisp8520
5 жыл бұрын
So buy insurance...
@user-td7xf3gz4l
5 жыл бұрын
Yes and people without home owners insurance "get screwed" when their house burns down
@evilbred974
5 жыл бұрын
@@dennisp8520 Ever consider some people can't afford insurance? Take all those fake 'sub-contractor' agreement where companies 'hire' someone to sub-contract on a $16 an hour retail or serve position. Now that person needs to buy all their own tools, uniforms and health insurance. Not sure if you are good at math, but when you make $2,900 a month before tax, it's pretty hard to afford good health insurance for your family.
@dennisp8520
5 жыл бұрын
@@evilbred974 I can do math and if you did it as well you would know that insurance always works out to be cheaper than paying out of pocket. Even if it's "bad insurance" it's better than no insurance at all
@h2lo704
5 жыл бұрын
Yeah, people without insurance gets crewed by the Pharma industry, while people with insurance gets crewed by the Insurance industry. It's a loose loose situation for the people but win win for the corporations. This is America where capitalism has gone rogue.
@rayeemon
5 жыл бұрын
I was really shook when I discovered this in Pharmacy school. PBMs a wild monster never heard to many
@emotionscomeandgo
5 жыл бұрын
Pbms are destroying small retail pharmacies to help cvs by not even paying the cost of the drug the pharmacy pays to get it. Its insane. They are truly the Villan here.
@auro1986
5 жыл бұрын
take out the middle men and make things cheaper
@faiyazabdullah9485
2 жыл бұрын
Because of the structure of the system you cant
@loganmarquis7378
4 жыл бұрын
Very well laid out for an individual or class. In no way is this “straightforward”, but the use of explanations and examples helps the audience understand more. Glad I got to see this and now I can engage in more educated debates on the topic and do more advanced research.
@bengt_axle
5 жыл бұрын
Very good explanation. I would like to see how the introduction of off-patent generic drugs influence the rebates negotiated for brand name drugs, and whether generic manufacturers are paying rebates to PBMs.
@AntonioCostaRealEstate
5 жыл бұрын
Now I can see why CVS bought the Pharmacy Benefits Program company and became Caremark.
@MusicGameFinatic999
5 жыл бұрын
Biggest pharmacy in the US for a reason!
@SteveWiIIDolt
5 жыл бұрын
@@MusicGameFinatic999 CVS is the least likely to catch drug interactions per a study by the Chicago Tribune. It is not safe to get your drugs there.
@MusicGameFinatic999
5 жыл бұрын
@@SteveWiIIDolt1. I don't 2. Wouldnt that technically be the fault of the doctor who is prescribing you the drugs, not the pharmacy? 3. Since CVS is the largest pharmacy in the United States I think statistics like that don't really mean much unfortunately.
@SteveWiIIDolt
5 жыл бұрын
@@MusicGameFinatic999 CVS is not the largest, that would be Walgreens. It is the pharmacists job to catch drug interactions, not just the doctor. Most patients see more than one doctor anyway.
@MusicGameFinatic999
5 жыл бұрын
@@SteveWiIIDolt also as far as the interactions go, it should be a combo of both right? The pharmacy just fact-checks the doctor's prescriptions if I'm not mistaken and makes sure there are no interactions or fishy business going on.
@MyLifeOfficial
5 жыл бұрын
The solution is simple: *Get rid of the entire concept of rebates* which also makes the "formulary" completely redundant . Have negotiators/committees directly employed by government/employers/insurance companies whose job it will be to drive down the price as much as possible. They don't get any kickbacks from anything, they get paid a salary that they are happy to work for and that motivates them to do the right thing.
@alvinsoehendrywijaya
5 жыл бұрын
Nope it dont work that way. We need to delete pbm. But negitiator works if you get % of profits. You know it like salesman work.
@Patmorgan235Us
Жыл бұрын
@@alvinsoehendrywijaya I don't have a problem with insurance companies hiring someone to negotiate on there behalf with the drug manufactures, but there needs to be an anti-kick back law put in place. the only person eligible to get a rebate from a drug company should be the consumer, not any of the middle men.
@MyLifeOfficial
5 жыл бұрын
That makes no sense. What is the point of increasing the list price of the drug and then giving rebates to Insurance companies, government and employers, apart from artificially creating an opportunity for a middleman/PBM to take their cut from it, and that too for adding 0 value to the transaction? It's crazy. If they were worth their cut, they would be able to justify it very easily (real estate brokers, financial advisers, car dealerships etc. can do this and so can many other professionals). They wouldn't need to hide behind the "proprietary" nonsense.
@SteveWiIIDolt
5 жыл бұрын
The rebates are a bribe from the manufacturer to the PBM. It should be illegal.
@camisetasnba
20 күн бұрын
I think that’s spot on the best way to define it. Helped me understand whats happening. Thank you
@nickgehr6916
5 жыл бұрын
*Pablo has a better simple way and it's cheaper to operate*
@raphaelcostantzer302
5 жыл бұрын
Zenn Lozanno Pablo escobar is dead
@jen_nice2059
5 жыл бұрын
Legalize crack
@zukacs
5 жыл бұрын
There was a video recently on some other channel where they basically said that US is subsidizing all the other countries where the drugs are cheap. Thx america for absorbing the costs of drug development and filling stockholders pockets
@mueffe1357
5 жыл бұрын
Its VOX. Its really Muricans fault for having these PBMs instead of open tender/decent govt healthcare like the rest of the world.
@zukacs
5 жыл бұрын
@@mueffe1357 I dont think that works in healthcare similar to aviation, only the big dudes have the resources and tools to develope new drugs
@priceofsilver
3 жыл бұрын
PBMs sound like that guy in Office Space who says he talks to the customers so the engineers don’t have to!
@kngu1911
5 жыл бұрын
PBMs steak from patients and the local pharmacy. The demand from the manufacturers and dictate limitations PBMs also create difficulties and cloud information from wholesalers that limit wholesalers to properly provide preferred pricing to pharmacies.
@raghavshankar8332
5 жыл бұрын
I love how Trump's statements were used for the problem definition of the video
@jen_nice2059
5 жыл бұрын
Raghav Shankar not they weren’t. They were used to underline the fact that the drug price problem is the result of a very complicated supply chain
@nsav8
4 жыл бұрын
Trump is the only politician that has attempted to address the high cost of prescription drugs. Hope he wins 2020 in a landslide.
@Raj-wf6ln
3 жыл бұрын
@@nsav8 even when he lost he still won
@usandmexico
4 жыл бұрын
Although it isn't a panacea, shopping around for drugs can dramatically reduce your cost at times. Every pharmacy I have ever called has answered my questions regarding price, and I have always gone to the cheapest. And whenever I get prescribed something like prescription strength ibuprofen, I buy the cheapest generic OTC and take enough to meet the prescription dosage.
@emilyv.3152
4 жыл бұрын
great way of explaining it, so glad you guys put this up!
@SteveWiIIDolt
5 жыл бұрын
This video is missing an important part of the equation. CVS owns a PBM, which it uses to force people to use it's own phamacy.
@diskographi
5 жыл бұрын
I hear you. So... cut out PBMs, take the money going to them and reduce the price of the drug at the Rx
@AntonioCostaRealEstate
5 жыл бұрын
Consumers or retailers ought to organize in Coops. This used to be a wining formula for the Aftermarket Auto Parts program when they went into programs such NAPA, Carquest, etc. To few pharmacy chains due to consolidation allowed this to fester through the 90’s . There ought to be more chains The Veterans Administration Program do not have such Shennaningans as the Medicare does , because they are not tied by laws passed through the Congress. They grind to the best bulk buying rate.
@carlosgarcia-jz3dq
2 жыл бұрын
if PBMs ran Mcdonalds a cheeseburger would cost $500
@JN-ox2yd
5 жыл бұрын
I came here to find out why my cocaine is so expensive and was disappointed
@summertime69
5 жыл бұрын
If PBMs are getting rebates and passing it on to the insurance companies to lower prices, and we know the insurance doesnt reduce their prices, so doesnt that just sound like a bribe to classify a drug into a tier that will sell more? If a PBM is getting a rebate, and throws some at the insurance company so the company will push the drug more, isnt that just a bribe?
@SteveWiIIDolt
5 жыл бұрын
That's exactly what it is. Unfortunately, the law allows it at this time.
@doriscastillo2232
3 жыл бұрын
The key word is is money making.
@binarydiver
5 жыл бұрын
Impressive video, good work WSJ. I think definitely the media of USA better than the media of South Korea.
@bgregg55
5 жыл бұрын
And US citizens get hosed for pharmaceuticals. They would be amazed how cheap they are in Mexico.
@norman3605
2 ай бұрын
How about a simple solution to this problem: Congress needs to repeal the single line passed in the 1987 Medicare Amendments that exempts GPOs ( an exemption later extended to PBMs) that exempts them from the Medicare Anti-fraud and kickback statute. Because these organizations do pay kickbacks to directly incentivise those persons (and not necessarily their companies or employers) who sign the service contracts. These legal kickbacks (aka rebates) would be a great topic for a follow up video by the WSJ.
@AcesizOfficial
5 жыл бұрын
Interesting
@Ashkanman
2 жыл бұрын
I still don't understand why distributers were mentioned at all. Only things mentioned were pharma companies, pbms, and insurance companies.
@NicholasLittlejohn
5 жыл бұрын
Taxpayers also pay for all of the research for these private profits.
@MyLifeOfficial
5 жыл бұрын
Rebates in this context, and "Formulary" sound like concepts some scammers and fraudsters would come up with if they were given the responsibility to handle this task for the benefit of society.
@whiterooksme
5 жыл бұрын
Well explained. Thank you.
@marks6663
5 жыл бұрын
I am in Canada. We have no insurance middleman. Our drugs are very affordable. I buy my drugs out of pocket and they are cheap. America needs to get rid of the all the middlemen that jack up the prices. The drug company makes the drug, you use it. That line needs to be as short as possible, not as long as possible. In the US, there are too many people trying to make money off of the regrettable fact that people need medication. Making healthcare a business and not a utility like the energy company, is what drives the cost of healthcare into orbit.
@JamesRendek
5 жыл бұрын
Thank you Mr. Ben Dover :)
@theblukatlife
4 жыл бұрын
Now do a video on how, why and who made this thing to happen in the first place
@mkevinbradley3930
2 жыл бұрын
PBM came in 1960's to process insurance claims. Gradually they took over everything.
@anthonymarquez6493
5 жыл бұрын
And what about the patients without insurance?
@kkirschkk
5 жыл бұрын
this system isn't designed for them sadly. They pay the full price
@Dear_Mr._Isaiah_Deringer
5 жыл бұрын
Supposed to go get their _Meds in Mex._
@Triplekia
5 жыл бұрын
They pay list price which can be absurdly high because its already jacked up to compensate the high rebate that being asked by insurance company.
@Dangic23
5 жыл бұрын
Drug price is the least of our problems. The intermediary health insurance companies are the largest problem in the US. Adding billions of dollars to the cost of healthcare with their bureaucracy.
@axeblue
5 жыл бұрын
and cortez was yelling at the pharma companies.
@AbuSous2000PR
5 жыл бұрын
Master piece
@judyl.7811
2 жыл бұрын
0:33 supply chain for prescription drugs. prescription drug coverage 處方藥費保險計畫 1:00 Pharmacy benefit management 藥品福利管理 understand the drug and money flow.
@JameBlack
5 жыл бұрын
True enmies of the people!
@CamRebires
4 жыл бұрын
Really well done WSJ, good job
@ankitk.pathak3977
5 жыл бұрын
Yaaaa
@SoomNou
2 жыл бұрын
You forgot to Add doctors getting bribes to write brand names
@SpencerKimber
2 жыл бұрын
All of this was good except for the conclusion. The patients don't pay the list price in almost all situations.
@Error_694
5 жыл бұрын
Step 1) They make the drugs Step 2) They rip you off
@ladhkay
5 жыл бұрын
Step 3) The US government lets them keep and renew patents for decades ensuring only they can make them
@boygenius623
Жыл бұрын
Actually, the description of how Pepsi works is inaccurate. Pepsi sells its concentrate to bottlers (many who are now vertically integrated with PepsiCo), the bottlers sell it to distributers, and the distributers sell it to retail stores.
@hussainmuammar6296
3 жыл бұрын
They need to get rid of the rebates and those PBM's.
@snakeboy2904
5 жыл бұрын
Good Vid. This pretty much sums up how PBM works. This is also a pretty good representation of how Hospital Bills get paid as well. All the contracted rates between the Hospital and Network are also "Proprietary".
@FiftymonkeysonAtree
3 жыл бұрын
All I see is two arrows going out from the customer 😂😂😂
@TakeNoPrisoners
2 жыл бұрын
The only leader I’d trust who’s be able to solve this con scheme in time
@Jadeserphant
3 жыл бұрын
This reminds me so much of high school. If you aren't in the "cool kids" group then your screwed.
@colt0110
5 жыл бұрын
Those who can't share information "PBMs" etc are the villains in this situation.
@kakalabrhm
5 жыл бұрын
Admit it *You clicked to know why your weed costs so much*
@shaneintegra
5 жыл бұрын
thought this was about recreational drugs... that would have been a good video!
@ChristianCarpesoChannel
4 жыл бұрын
Wow! This is so confusing
@abrahamdecruz5128
2 жыл бұрын
That's in the USA. What about in other countries where there are no.pbm's but the cost of drugs is still high? How do you explain that? One can only see the drug companies trying to milk their profits.
@ruzzelladrian907
5 жыл бұрын
Should drug companies sell straight to consumers instead? Sort of like what Apple and Tesla did? But my hunch is that some bureaucratic crony politician might put out a law that makes direct selling illegal.
@dennisp8520
5 жыл бұрын
No direct sale should be illegal because consumers are stupid. It's bad enough in the states that we have drug ads telling people to see their doctor for a certain pill. Drugs should only be taken when prescribed by a doctor. They should not be sold directly because dosage matters. There are already drugs that get sold over the counter that are cheap thanks to patents wearing off and the same will eventually happen with the drugs of today.
@kolektivmozak238
5 жыл бұрын
Corruption at it's highest.
@paulhetherington3854
8 ай бұрын
1. drug
@jzk2020
5 жыл бұрын
How would you disrupt that whole industry? Could you make a video on that. It might inspire the next Elon Musk / Uber / Jeff Bezos etc.
@GeliCarlosJ
5 жыл бұрын
they should just remove PBM’s and then make the CDC or whatever decide what drug goes on where in the formulary. PLUS government should regulate prices by pharma companies
@YuraEnjoji
5 жыл бұрын
yeah but that's socialism. That's a big no-no in The States.
@ten_tego_teges
5 жыл бұрын
Heck, the best part is that Medicare cannot negotiate their own prices. The law literally cripples the government insurer, cause God forbid they negotiate the best prices having 60M customers. The guy who passed this law in 2003 under Bush, got a tasty position in a pharma lobby group. Look up Billy Tauzin and the Medical Modernization Act of 2003.
@schanemassey3861
5 жыл бұрын
CLICKBAIT! I thought it was going to talk about street drugs, cocaine, crack, meth, pcp, angel dust, heroin, molly, green goblin, sunset powder, Indian kusma etc.
@AnhTuPhucDerrickHoangCanada
2 жыл бұрын
This is all behind the times. They should prepackage doses.
@prasadkadu9737
3 жыл бұрын
I got baited .. i thought they were going to be talking about the Drugs of drug lords
@Subvisual
5 жыл бұрын
It's just an elaborate series of kickbacks to maximize insurance company and drug manufacturer profits and leave the consumer/taxpayer footing the ever increasing bill.
@rosinamartinez6322
Жыл бұрын
Altogether this is not fair for the customers who have to pay for drugs we are always paying and paying and getting the lower end of the stick. We pay taxes every year, we pay car insurance, house insurance, medical insurances and they still stick to us in doctors and drugs. What more do they expect to do to the customers drain us of whatever money we have left? The government should have stopped all these business from getting our of proportion and limit them to what they can do. Or is this a country where the rich keep getting richer and the poor pooer with no end in sight. There were times way back when the government put limitations of what the insurances and all those companies would put controls on them, not now anymore?
@jcost2012
5 жыл бұрын
Greed is the main driver of their prices..
@Aman-kn5iv
5 жыл бұрын
Not for dis vid couldnt find the real one
@user-xd4sk4pk7h
5 жыл бұрын
*laughs in european*
@yangliu3905
3 жыл бұрын
The list price $100, with 50% off is same as list price $50.
@manuelcunharocha8889
5 жыл бұрын
WSJ, did you get the idea for this videos from Cheddar ?
@hassaan3861
5 жыл бұрын
Too bad cheddar can't even come close to explaining stuff properly
@Alduinsshadow148
4 жыл бұрын
It seems like the video is missing something, like government policy or regulation on intellectual property rights for drugs/R&D.
@christiantioye5171
4 жыл бұрын
I think the cost of R&D as well as bringing drug to market should be already included in the list price of the drug, which is set by the manufacturer. This video is concerning the extra costs being added by the middle men in the supply chain, causing the final cost to the consumer to be several times higher
@reynanhenry612
5 жыл бұрын
Why pharma companies dont make their own insurance company? This eay they can lower insurance price because there will be no more pbm and they can increase their profit because there will be no more rebate
@amycuaresma
2 жыл бұрын
Pharmacy benefit managers:
@VipinChanders
3 жыл бұрын
In India as per disease you have valid for policy...and specific hospital and doctor confirmed the your money's back or goes to company..if you have policy than hospital charged more than actual rate...adjust with it govt & company... We are totally opposite...in every manner...shop keeper will make money and patience is with empty hand.....
@oraromaochi5584
5 жыл бұрын
Wait a minute, Trump outlined the supply chain perfectly??! 0:58
@mahendrakumarshanu8047
3 жыл бұрын
I didn't get that complex system I mean if the drug leveled as $100 and consumer have to pay suppose 20 of it then suppose 50 discounted to insurance companies so they will pay $30 of it right . so that means the drug cost only $50 isn't it..just levelling it as 100 doesn't make any difference I think its the insurance companies having control and manipulating the system because out of pocket became extremely costly.... correct me if i am wrong above
@evilbred974
5 жыл бұрын
The 'invisible hand of the market' making America great again.
@WhatTheF0K
4 жыл бұрын
Every Doctor that writes a script gets a big commission.
@pstha4537
3 жыл бұрын
why dont they just sell it like a regular product. i don't get it.
@paladin696969
5 жыл бұрын
Sorry I was looking for the price of street drugs
@minahilalvi9169
5 жыл бұрын
Ahahhaahah same!😂
@sethsmith2161
5 жыл бұрын
The title was a bit click batty ( I thought it was like illegal drugs)
@michaelsmith953
5 жыл бұрын
lol me too but i mean learning how your legal drug dealer charges you extortionate amounts is just as interesting as how your illegal one does
@LittleRadicalThinker
5 жыл бұрын
So who pays for the drug price? The ones who can't afford the insurance, maybe government too.
@1Esteband
4 жыл бұрын
Just make rebates and kickbacks of any kind ilegal and will force the chain to reorganize
@Plainsburner
2 жыл бұрын
They are not only legal in the US, but government mandated.
@usandmexico
4 жыл бұрын
The supply chain for producing Pepsi is oversimplified. Also, did Pepsi pay WSJ to advertise their product?
@eros7872
Жыл бұрын
I am exporting pharmaceutical products
@alexmikhylov
5 жыл бұрын
that sound like a scam
@Hi-pu7up
5 жыл бұрын
Hello
@ShivamGoyalSG
5 жыл бұрын
does this even make sense !!
@AlbertSeagram
Ай бұрын
Why don’t pharmaceutical companies just reduce the list price to make drugs more affordable? Rather than paying rebates to insurance companies - it would cut out the insurance company and the pharmaceutical companies would make the same as if they were paying a rebate
@j.ericsandoval566
5 жыл бұрын
This is missing information, AKA lying. YOU paid for the R&D for these drugs to be developed. In other words, it’s SUPPOSED TO BE OPEN SOURCE, as in it’s supposed to be cheaper. You’re being lied to. Pharmaceutical companies have been receiving subsidies for more than twenty years and then some. But now they just trade in patent exclusivity.
@alexisrojas3584
5 жыл бұрын
Thought it was the other type of drugs
@Zayden.
5 жыл бұрын
Expropriate the billionaires in the pharmaceutical industry.
@shapurr5949
5 жыл бұрын
from the video it seems it's the insurance companies causing most trouble
@Randomgoatlol
5 жыл бұрын
@@shapurr5949 If the information from the video is correct. It's all on the insurance companies.
@taubevictor8989
5 жыл бұрын
I get if from a guy named scrappy..."
@Jonifico
5 жыл бұрын
I thought this video was about the other drugs...
@szemhaz8721
3 жыл бұрын
It's like everyone profits except the consumer. Great.
@FunBuddy1
2 жыл бұрын
What's in india
@uk7153
5 жыл бұрын
Fixed copay percentage, make it illegal for pharmacies to give rebates... solution is simple, but lack of political will is reason. (Oh they get rebates too, ironic. It’s just given a different name)
@omarmahfouz5599
3 жыл бұрын
Kickbacks
@Plainsburner
2 жыл бұрын
Government created the need for PBMs and politicians get 3 million out of them every year.
@roismartin
5 жыл бұрын
Who else came into this video to know about illegal drugs and ended up disappointed?
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