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【drug-news】仿制药便宜，但还可更便宜
Generics Are Cheap, but They Could Be Cheaper
Posted by Sarah Rubenstein
pharmacyGeneric drugs are viewed as a rare bright spot when it comes to the cost of the U.S. health-care system. By switching to them, patients can often save a bundle.
But for some in the health-care industry, generics can mean big money. And the irony is that patients often don’t realize their savings from generics could be much bigger. As this WSJ article from last year explains, pharmacies often significantly mark up the prices of generics when they sell them to the uninsured. And as the WSJ reports today, pharmacy benefits managers are keeping a big share for themselves when the insured buy generics.
Here’s how it works: Many health insurers contract with PBMs to administer their drug plans. Among other functions, the PBMs negotiate lower drug prices with pharmacies. But some PBMs, under a practice allowed by Medicare, then charge a higher price to health insurers and, ultimately, both the government and patients. Though the opaque practice is common in the private insurance market, Medicare currently has a proposal to curb it, because the agency is worried the tactic, by inflating patients’ drug costs, is speeding their pace toward the “doughnut hole” coverage gap.
The differences between what the PBMs pay pharmacies and what they charge the plans can range from a few dollars to well over $100. In one case, a Medicare patient filled a prescription for a 90-day supply, or 270 pills, of the generic antinausea medication prochlorperazine. The difference between what the PBM, Express Scripts, paid the pharmacy and the price that showed up on the patient’s explanation of benefits was $146.53.
Express Scripts spokesman Steve Littlejohn said it is “extremely rare” for price differences to get above $100, and it occurred in this case because the patient purchased the drug at a quantity greater than is typically prescribed. Broadly, Littlejohn said that PBM pricing on generics “is very competitive, and is generally far better than [uninsured] cash-paying customers obtain on their own.” Meanwhile, the money Express Scripts makes on generics, he says, helps fund programs that drive patients away from branded drugs and toward generics that ultimately still cost less. Overall, the company makes a “single digit” per-perscription profit margin, he adds.
Other companies that sometimes use this type of pricing in Medicare include CVS Caremark and UnitedHealth. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 仿制药便宜，但还可更便宜
July 22, 2008, 5:03 pm
Generics Are Cheap, but They Could Be Cheaper
Posted by Sarah Rubenstein
Pharmacy Generic drugs are viewed as a rare bright spot when it comes to the cost of the U.S. health-care system. By switching to them, patients can often save a bundle.
当谈到进入美国卫生保健制度的成本时，药业的仿制药被认为是罕见的亮点。通过使用仿制药，病人能经常省不少钱。
But for some in the health-care industry, generics can mean big money.
但是对医疗保健业的人而言，仿制药可能意味着挣大钱。
And the irony is that patients often don’t realize their savings from generics could be much bigger.
同时令人讽刺的是病人经常没有意识到从仿制药中节省的费用能更多。
As this WSJ article from last year explains, pharmacies often significantly mark up the prices of generics when they sell them to the uninsured. And as the WSJ reports today, pharmacy benefits managers are keeping a big share for themselves when the insured buy generics.
就像去年这篇华尔街日报中文章的解释，当销售给非医保病人时，药房经常明显抬高仿制药的价格。同样如今天华尔街日报的报道，当医保病人购买仿制药时，药房的利润经理能分享其中很大一部分。
Here’s how it works: Many health insurers contract with PBMs to administer their drug plans.
这是它如何运作的：许多医疗保险公司与PBMs接触，采用它们的药物策略。
Among other functions, the PBMs negotiate lower drug prices with pharmacies.
在其他职能外，PBMs负责与药房谈判降低药品价格。
But some PBMs, under a practice allowed by Medicare, then charge a higher price to health insurers and, ultimately, both the government and patients.
但是医疗保险允许的操作中，一些PBMs接着向医疗保险公司及最终的政府和患者要价更高。
Though the opaque practice is common in the private insurance market, Medicare currently has a proposal to curb it, because the agency is worried the tactic, by inflating patients’ drug costs, is speeding their pace toward the “doughnut hole” coverage gap.
虽然这种不透明的操作在私人保险市场是非常普遍的，但是目前医疗保险有一个方案去遏制制它，因为政府机构担心其策略能使病人药品价格的膨胀加快，就像“甜圆洞”边缘的差距越来越小。
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作者:admin@医学,生命科学 2011-06-20 23:48
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