Statistical analyses were performed using SAS release 9.2 (SAS Inst
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Theres very little direct negotiation compared to other parts of the world, and the result is that patients pay the price. Acting as middlemen, PBMs negotiate drug prices on behalf of insurance companies and have been accused of prioritizing their profits over patient access
Major health plans and PBMs have built institutional knowledge of how to structure formulary decisions, step therapy requirements, and prior authorization criteria to accelerate biosimilar adoption and have financial incentives to deploy that knowledge more aggressively than in the adalimumab cycle
You may have seen the term "Ozempic face" in the news