July 11, 2019

A recent report from the Massachusetts Health Policy Commission used publicly available drug pricing data in an attempt to identify proxies to highlight the differences between what health plan sponsors reimburse their pharmacy benefit managers (PBM) for a prescription versus what the PBMs reimburse pharmacies, otherwise known as “spread.” HPC also compared Medicaid Managed Care Organization (MCO) reimbursement with Medicaid Fee-For-Service (FFS) reimbursement rates.

Visante replicated the HPC analysis and then examined the data sources, methodologies, and conclusions for flaws and/or potential sources of error.

Read the Visante analysis here