GLP-1 prices dropped. Yours didn't.

Let’s talk about the price of GLP-1s: Did you know that manufacturers have significantly lowered the prices for most GLP-1s over recent years?

Oh, not your price - that’s gone up.

But your insurer or PBM, their price has gone down.

Below is a chart showing list (the price you pay if your insurance doesn’t cover the drug and you have to pay cash) and net (the negotiated rate your PBM pays) for the class of drugs since 2017. The chart came from this great report: https://lnkd.in/eduQMAwB

Read it from left to right by drug and you’ll see that the trend is that list goes up and net goes down.

What’s happening?

Sophisticated negotiations in someone else’s best interest.

Big PBM’s negotiate with Rx manufacturers to drive up list prices to drive bigger rebates back to PBMs, which they may (or may not) share with the plan and participants in the form of a rebate.

Big PBMs use their “buying power” (read: you) to get more rebates in exchange for preferred placement on their formularies.

But here’s a question: if Novo Nordisk is willing to sell Ozempic for ~$300/month, what are we getting from a big PBM if the price we pay is far above that?