Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburse the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction.
Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency.
By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies.