Big Three PBMs Love Tax Havens, Pharma Slashes Prices to Make More Money, ChatGPT Plays Doctor with Your Data

Hey all,

Happy Thursday! The sheer opacity of our current system means we now have PBMs funneling billions of American dollars into Swiss and Irish bank accounts, while drug manufacturers simultaneously realize that slashing list prices to let 340B mechanics work as intended is actually the most effective way to boost revenue. It is a unique financial ecosystem where dropping prices avoids penalties and raises income, yet we still need 12,000-word exposés just to track the rebates vanishing overseas. Ultimately, these maneuverers make perfect, distinct sense, provided you are an expert in US healthcare and not a regular human being trying to afford a prescription.

Enjoy the rundown! 

Jacob Brody, (Co-Founder & CEO, ZorroRX)

(Hunterbrook Media) PBMs Use Secretive Subsidiaries to Hide Billions

In an exhaustive 12,000-word exposé that might actually take longer to read than waiting on hold for insurance approval, Hunterbrook Media reveals how the "Big Three" PBMs have established secretive subsidiaries to funnel billions in drug manufacturer rebates away from patients and health plans. By reclassifying standard rebates as "administrative fees" processed through these shell-like Group Purchasing Organizations (GPOs), healthcare giants like CVS, UnitedHealth, and Cigna can legally bypass contracts that require them to share savings, driving up costs and restricting patient access to life-saving medications. It is surely just a staggering coincidence that these "indispensable" value-add entities are headquartered in tax havens like Ireland and Switzerland, considering their revenue is derived almost exclusively from American businesses, American taxpayers, and the wallet-draining copays of American patients. Full Article

(The Arc) Dropping Drug Prices Can Mean Rising Revenue

Brian Reid highlights Ironwood Pharmaceuticals' strategic decision to halve the list price of Linzess, arguing that this move will actually boost revenue by sidestepping massive inflation penalties associated with Medicaid and 340B pricing. He explains that since high list prices are frequently eroded by rebates anyway, lowering the sticker price reduces liability without necessarily harming the net income manufacturers receive. It is truly a shocking discovery that if you simply refrain from setting astronomical sticker prices, you might conveniently avoid the government penalties specifically designed to stop you from setting astronomical sticker prices. Full Article

(Fierce Healthcare) OpenAI Launches ChatGPT Health for Personalized Medical Data Integration..

OpenAI has introduced ChatGPT Health, a new feature powered by b.well Connected Health that allows users to securely connect their electronic health records and wellness apps to the chatbot for personalized, context-aware medical insights. The system is designed with specific encryption and privacy protocols to ensure that sensitive health data is used solely for user queries and not for training OpenAI’s foundation models. Given that the AI sometimes still confidently insists Joe Biden is the current president, I think I’ll stick to double-checking its medical advice with an actual medical professional. Full Article