The report explores a controversial practice called spread pricing, where PBMs pay drugstores one price for a treatment while charging more to their health plan clients. Critics of the practice say the difference in pricing adds to PBMs profits.
The report found that Kentucky Medicaid insurers paid $957.7 million to the four PBMs that the state program works with. Of that amount, PBMs kept 13 percent of $123.5 million through using the pricing tactic.
The size of the spread has increased by more than a third since 2017.
Companies that run the PBMs in the state’s Medicaid program, including CVS Health and Cigna, claim their clients knowingly enter into the spread-pricing agreements and that those agreements help fund benefits for patients and stabilize drug costs.
Read the full report here.
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