As Drug Prices Rise, Some Pharmacists Opting Out Of Insurance System

Record-high drug prices are frustrating many Americans. It's lead to more pharmacists opting out of the insurance system.

There's a small but growing number of “cash” or “self-pay” pharmacies. They offer generic medications at wholesale prices, usually with a small markup. By opting out of the insurance system, these pharmacies avoid potential fees and other regulations that increase costs. David Balat, with the Texas Public Policy Foundation, says doctors, physical therapists, and other medical professionals are looking at other options as well.

“Their reimbursements continue to decrease, while insurance companies continue to increase premiums and coinsurances and deductibles,” Balat said.

He adds part of the reason drug prices are so high is because most of the money you pay either goes to the insurance company or the Pharmacy Benefit Managers, who negotiate the prices. That's why there's a push by some lawmakers for more transparency.


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