I filled a prescription recently, and the drugstore said they wanted more than 700 bucks… for an old-line generic drug. My insurance ended up knocking that down, but it was WEIRD. And it meant a big homework assignment for me.





Luckily, I got help. Both from some experts, and from the classic Christmas movie It’s a Wonderful Life (source of the pictures above and below, of course).





I mean, what I actually learned was not a hundred percent cheerful.

We get these unpredictable prices thanks to companies that — surprise! — make a big profit from driving prices up. (They’re called “pharmacy benefit managers” — PBM for short.)

Theoretically, they work for insurance companies and employers who pay the premiums, and they’re supposed to keep drug prices down.

Economist Geoffrey Joyce used to think they did OK at that, but he’s changed his mind.

One thing that turned him around:

They got sued in several states, saying, ‘Hey, you should be acting in the best interest of your clients.’ And they’ve won in court saying, ‘No, we have no obligation to do what’s best for our clients. We do what’s best for us.’

So, not all sunshine. 

But: Feeling a little smarter about the whole thing? It’s a victory. Also kinda fun.

I filled a prescription recently, and the drugstore said they wanted more than 700 bucks… for an old-line generic drug. My insurance ended up knocking that down, but it was WEIRD.&nbsp;And it meant a big homework assignment for me. Luckily, I got help. Both from some experts, and from the classic Christmas movie It’s a Wonderful Life (source of the pictures above and below, of course). I mean, what I actually learned was not a hundred percent cheerful.We get these unpredictable prices thanks to companies that — surprise! — make a big profit from driving prices up.&nbsp;(They’re called “pharmacy benefit managers” — PBM for short.)Theoretically, they work for insurance companies and employers who pay the premiums, and they’re supposed to keep drug prices down.Economist Geoffrey Joyce used to think they did OK at that, but <a href="https://www.marketwatch.com/story/an-economists-change-of-heart-its-time-to-regulate-the-prescription-drug-middlemen-2018-08-13" rel="noopener noreferrer" target="_blank">he’s changed his mind</a>.One thing that turned him around:They got sued in several states, saying, ‘Hey, you should be acting in the best interest of your clients.’ And they’ve won in court saying, ‘No, we have no obligation to do what’s best for our clients. We do what’s best for us.’So, not all sunshine.&nbsp;But: Feeling a little smarter about the whole thing? It’s a victory. Also kinda fun.

An Arm and a Leg is a podcast about why health care costs so freaking much and what we can (maybe) do about it.

If you’ve ever been surprised by a medical bill, you’re in good company. But as our team of seasoned journalists has learned from years of reporting — you’re not always helpless. We don’t have all the answers, but we’ll offer you tools and big picture insights with plenty of humor and heart. 

An Arm and a Leg is co-produced with KFF Health News and distributed in partnership with KUOW.

You can support An Arm and a Leg by donating at armandalegshow.com/support/

Show Credits: Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.

An Arm and a Leg&nbsp;is a podcast about why health care costs so freaking much and what we can (maybe) do about it.
If you&rsquo;ve ever been surprised by a medical bill, you&rsquo;re in good company. But as our team of seasoned journalists has learned from years of reporting &mdash; you&rsquo;re not always helpless. We don&rsquo;t have all the answers, but we&rsquo;ll offer you tools and big picture insights with plenty of humor and heart.&nbsp;
An Arm and a Leg is co-produced with <a href="https://kffhealthnews.org/">KFF Health News</a> and distributed in partnership with <a href="https://www.kuow.org/">KUOW</a>.
You can support An Arm and a Leg&nbsp;by donating at <a href="https://armandalegshow.com/support/">armandalegshow.com/support/</a>
<hr>
Show Credits:&nbsp;Created, hosted, and produced by Dan Weissmann with senior producer Emily Pisacreta and engagement producer Claire Davenport, edited by Ellen Weiss. Audio wizard: Adam Raymonda. Music is by Dave Weiner and Blue Dot Sessions. Bea Bosco is our consulting director of operations. Lynne Johnson is our operations manager.

An Arm and a Leg

I filled a prescription recently, and the drugstore said they wanted more than 700 bucks… for an old-line generic drug. My insurance ended up knocking that down, but it was WEIRD.  And it meant a big homework assignment for me. Luckily, I got help.

Advertisement