ProPublica, December 9, 2017
Charles Ornstein, ProPublica, and Katie Thomas, The New York Times

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[...] In an era when drug prices have ignited public outrage and insurers are requiring consumers to shoulder more of the costs, people are shocked to discover they can sometimes get better deals than their own insurers. Behind the seemingly simple act of buying a bottle of pills, a host of players — drug companies, pharmacies, insurers and pharmacy benefit managers — are taking a cut of the profits, even as consumers are left to fend for themselves, critics say.

Although there are no nationwide figures to track how often consumers could have gotten a better deal on their own, one industry expert estimated that up to 10 percent of drug transactions involve such situations. If true nationwide, that figure could total as many as 400 million prescriptions a year. The system has become so complex that "there's no chance that a consumer can figure it out without help," said the expert, Michael Rea, chief executive of Rx Savings Solutions, whose company is paid by employers to help them lower workers' drug costs. [...]

health care finance insurance pharmaceuticals public health regulation