If you guessed the manufacturer, you’d be wrong.At least according to a new study Mattingly et al. (2023) in JAMA Health Forum. Using a sample of 45 generic drugs in Part D valued at more than $100 million and used by more than 1 million beneficiaries, the authors found:
…Medicare Part D spent $11.8 billion on 690 million claims (average $22.50 per claim; 95% CI, $18.28-$26.72 per claim), accounting for 5.5% of all Part D spending in 2021 ($216 billion) %. The $22.50 is divided as follows: $9.18 (40.8%) represents PBM gross profit; Pharmacy gross profit is $3.87 (17.2%); Wholesaler gross profit is $2.71 (12.0%); Manufacturer revenue is $6.73 (29.9%). Total intermediary gross margins (PBMs, wholesalers, and pharmacies) accounted for -12.3% to 88.6% of Medicare Part D spending.
The full text is here.
