U.S. high-priced drug channel reform: breaking the PBM monopoly

The introduction of the dual-channel model of high-priced drugs in China has aroused market attention, and in the United States, changes in the sales channels of high-priced drugs have also attracted market attention.

Unlike Chinese outpatient drugs which are mainly sold in hospitals, American outpatient drugs are mainly sold outside the hospital through PBM.

As a result, PBM's relationship with payers in the United States has become increasingly strained, which ultimately prompted its merger with insurance companies.

Although the US retail pharmacy market is highly concentrated, there are still a large number of small and medium-sized pharmacies in the field of new specialty drugs.

Through these two methods, PBM keeps its drug income in its own body instead of giving it to other independent pharmacies, so that it can further increase its income.

In fact, not only independent pharmacies, the market share of specialty drugs is increasing, and hospitals cannot resist the temptation of this market.

Hospitals want more patients to stay in the hospital to buy medicines, but insurance companies often divert patients to their own pharmacies outside the hospital.

Therefore, as the U.

From the perspective of the reform trend of specialty medicine channels in the United States, breaking the monopoly of prescription drug sales is the core, which has a similar starting point with China's dual-channel model.