Why do you think this phenomenon would exist in a price sensitive market? You mention this data doesn't include rebates and possibly other factors. On its face, this seems to be an incomplete analysis.
I think the market is at best imperfectly price sensitive. There are many examples where an employer will pay a higher price than is available when getting the lowest price would involve complexity.
In this post from October (https://employercoverage.substack.com/p/biosimilars-are-finally-widely-available) I point out that for adalimumab the cost of PBM-branded biosimilars is about twice the cost of other available biosimilars. Also, the total costs at Mark Cuban, Costco and Walmart for commonly used inexpensive generic medications tend to be much lower than the costs from PBM mail order. (See this post: https://employercoverage.substack.com/p/online-direct-to-consumer-outlets). But the complexities of using these consumer outlets (such as accumulating for the deductible) mean that employers continue to use the PBM mail order shops.
As you note, this analysis does not include rebates.
Why do you think this phenomenon would exist in a price sensitive market? You mention this data doesn't include rebates and possibly other factors. On its face, this seems to be an incomplete analysis.
Thanks for your comment and question, Jeff.
I think the market is at best imperfectly price sensitive. There are many examples where an employer will pay a higher price than is available when getting the lowest price would involve complexity.
In this post from October (https://employercoverage.substack.com/p/biosimilars-are-finally-widely-available) I point out that for adalimumab the cost of PBM-branded biosimilars is about twice the cost of other available biosimilars. Also, the total costs at Mark Cuban, Costco and Walmart for commonly used inexpensive generic medications tend to be much lower than the costs from PBM mail order. (See this post: https://employercoverage.substack.com/p/online-direct-to-consumer-outlets). But the complexities of using these consumer outlets (such as accumulating for the deductible) mean that employers continue to use the PBM mail order shops.
As you note, this analysis does not include rebates.