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Health insurers could start their own prescription drug outlet malls.
Analysts at Avalere Health talk about that possibility in a new report on the TrumpRx.gov project and other "direct-to-consumer" prescription drug sales programs.
Today, the best-known direct-to-consumer drug sales programs have operated on a cash-pay basis, with no direct connections to the patients' health plans.
The cash-pay programs may keep pricing simple, but using a cash-pay program "may not be a viable option for many patients," the Avalere analysts write.
If insurers started their own "insurance-integrated" drug sales programs, that could lower what the patients pay out of pocket to use the programs and encourage more patients to try the programs, the analysts say.
An insurer with its own program might also have an easier time finding out how well the patients were taking their medications and supporting efforts to detect side effects, the analysts add.
What it means: Avalere analysts help insurers, employer plan sponsors, benefits advisors, program administrators and government policymakers design and understand health programs.
If Avalere analysts say health insurers could start their own direct-to-consumer prescription drug sales programs, that could be a sign some insurers already have drug outlet mall blueprints under development.
Direct-to-consumer drug sales sites: Mark Cuban, a "Shark Tank" alum and entrepreneur, helped draw attention to the idea of direct-to-consumer drug sales programs by starting Mark Cuban Cost Plus Drugs, an online pharmacy that charges customers the manufacturer's wholesale plus for a drug along with a standard dispensing fee.
Officials in the administration of President Donald Trump recently began trying to support the direct-to-consumer sales program effort by announcing plans to start TrumpRx.gov.
The TrumpRx.gov website will help drug manufacturers sell brand-name prescription drugs directly to consumers, officials say.
The TrumpRx.gov website could help manufacturers hold down the full retail prices of the drugs offered by cutting out pharmacy benefit managers and other middlemen, organizers say.
PBM executives argue that they have had great success at holding down prices for most generic drugs in the United States and are having some success with controlling prices for brand-name prescription drugs.
The PBMs' critics say traditional PBMs have a financial incentive to increase drug prices, because traditional PBMs often tie at least some of their compensation to the amount of discounts they negotiate for employer health plan sponsors and other customers.
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