Lately, though, some people have come to wonder if PBMs serve much of a purpose at all, other than skimming off profits for themselves. That's because the PBM have an enviable position in the middle of all this. It can pay the pharmacy $110 for Pretendar but bill the insurance company for $140. It keeps $30 for itself. This is called spread pricing. But those two prices are protected by confidential contracts. So neither the pharmacy nor the insurance company knows what the other received.
So we have this middle man added in here that is taking a $30 vig off the top here by sending a bill to the insurance company? Plus the insurance company and the pharmacy don't even know what the correct price of the prescription is? Why isn't this regulated better?