PBM markets for Medicare Part D or Medicaid are highly concentrated in nearly every state
Just three pharmacy benefit managers (PBM) dominate retail prescriptions in Medicare Part D and Medicaid managed care across much of the country, with markets in in nearly every state considered highly concentrated for at least one program, according to a new study from the USC Schaeffer Center for Health Policy & Economics.
The study, published Feb. 6 in JAMA Health Forum, provides one of the most detailed examinations to date of PBM competition within states. Based on a federal antitrust index, the authors find:
40 states have highly ...