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For the past few years, it has become difficult to afford medicines in the United States. There have been many reports making headlines nowadays on how people are losing their life because they couldn’t afford proper health care. There are very few companies who compete in the drug market and they mostly spend their money on advertising instead of working towards a solution to reduce the prices. The people who can afford such highly-priced drugs are keeping their mouth shuts and people who cannot afford them are being silenced in this complicated system. Access to proper medical health care should be a right that every human being should be given.

A prescription for Humira is an injectable medication that treats a lot of common conditions like arthritis and psoriasis. Its one-month supply’s average cost is $7,037.81 making it the most expensive drug in the United States. Some people sell their life possessions just to afford the medications. Insulin is essential as it is a natural hormone that controls blood sugar levels in our body. An increase in blood sugar can cause vision loss, nausea, organ failure or a decrease of it can cause heart irregularities, mood swings, seizures and you can faint. These small vials used to be sold for $1 back in 1923 when it was first discovered so that it can be affordable and be available to the general public who needed it. But now that purpose seems to be lost somewhere.

When it comes to pointing fingers, people blame the pharmaceutical companies, who then blame the government regulations and insurance providers. But now slow changes are happening with third-party negotiators called the PBM.  

What does the third-party PBM do?

Many insurance companies enlist them, to fix discounts with drug manufactures so that the co-payment that patient gives out from their pocket is reduced.

The third party that was involved and is the Pharmacy Benefit Manager (PBM). According to the American Pharmacists Association, they are responsible for:

Developing and maintaining the formulary (List of Medications)

Contracting with Pharmacies

Negotiating discounts and rebates with drug manufacturers

Processing and paying drug claims.

The founder and CEO of RxParadigm Mesfin Tegenu stated that “For all intent and purposes, transparency and competitiveness do not exist in the prescription drug market because of an outdated drug rebate negotiation culture that allows a select few companies to see higher margins and, in turn, dominate the entire prescription drug ecosystem.”

The high drug prices have become an increasing issue in today’s day and age. A lot of people can’t afford pharmaceutical drugs because of their unreasonable costs. This has put the country in a dismay. Medicinal drugs should be affordable for all as their health is a primary concern. If the citizens aren’t able to function properly then it will in-turn be detrimental to the country’s economy. The major problem with the pharmaceutical companies is that they focus on treating symptoms rather than finding cures of the ailments. It will be much easier if the root cause is treated and eliminated. Drugs like that would revolutionize the market. Instead of finding real cures to heal people, they are postponing it by finding ways to treat the symptoms.

If a real cure is found, then it would drastically reduce the prices of the drugs. It would increase the competition in the market. People would use the drugs to reduce the symptoms but they would be assured if a real cure is out there in the market. The Pharmaceutical industry along with other health companies should spend money and resources into finding an actual cure. Most companies want to capitalize on the drugs as even a slight competition would lower the drugs’ prices.

It is important to keep the citizens’ health as the number one priority. If the drug prices are lowered then it would in-turn increase the sales and would bring in more profit. But the US pharma companies and the government want to retain their position as being the top producers of high-quality medicines in the world. But, investing more in a cure would retain their position and drastically improve their citizens’ health. But the risk is high. If a cure is not found or attained, billions of dollars and time will be wasted. So, creating and providing high-priced, symptomatic drugs is a safer bet.

The competition subject is consistently open to banter in medical services, and drugs are no particular case. In today's world, especially the medical market, numerous manufacturers can synthesize various medical products. As a result, there is a sense of constant competition in the market as the best medicinal drug will be considered the primary option for curing and treating a disease or condition. Thus, in a way, competition in pharmaceutical companies' marketplace is a rather impactful and thoughtful phenomenon.

It is no surprise that most of the drug organizations today are multinationals and corporate companies. As a result, numerous public contrasts have been smoothed, the presence of a significant public drug industry has verifiably influenced the general strategies of the worldwide nations. As the world keeps getting smaller and more connected, far more brands, both local and international, are on their trails to become the most renowned medical market. However, the ordinary people are always in the benefit.

A contest of various products and their prices

A wide range of products may sometimes be confusing for both the medical houses that sell these drugs and the customers who buy them. However, this issue is resolved by other third party organizations that test these drugs and rank the best ones in the pool.

Nonetheless, the confusion remains due to the difference in price segments of these products. In general, there are no drastic differences in the prices of various medical products. Still, due to the availability of such a varied medicinal stock, the consumer may sometimes be overwhelmed.

Powers outside of the business are likewise enormous as they are prepared to do influencing all organizations inside the company. Subsequently, what is significant is the limit of firms to manage these external powers viably. Since the sense of competition in an industry is established in its fundamental financial design, the level of determination that exists works out positively past current contenders' conduct. The story of competition in an industry relies upon several essential factors, including brands' participation, whose system strength decides the business's definitive benefit and capability.

Although medical experts are known to prescribe the best medicine available in the market, such a considerable rise in medicinal availability is defiantly worth admiring.

A note of positivity for the patients

The pharmaceutical industry competition may seem disturbing from a distance, but the medical experts and practitioners know the best course of action for such drugs. As such, a customer or a patient need not worry about the quality and potency of medicines they use or receive from the departmental stores.

A Pharmacy Benefit Manager, which is otherwise called a PBM, is an association that offers several types of assistance, instructive projects, and administrations to help patients. These organizations do this by influencing drug specialists and medicine manufacturers' practices to recommend medications suitable for amplifying their viability. Thus, a PBM function plays a crucial role in ordinary people's well-being as it makes sure everything regarding medicines and medicinal usages are functioning at optimum levels.

The PBM is a middle person among safety net providers and different individuals from the medical services industry. As a result of their size, they can haggle enormous client contracts and compromise with drug stores and pharmaceutical organizations to get the best rates. This makes sure that every citizen receives the best medicine for their concerns and manages the deal's monetary side.

Individuals that work and serve in the medicinal sector should know which PBM is prevalent in the market. Enormous organizations have the best influence to arrange repayment rates for drugs and patient consideration administrations. As a result, owners and managers of all pharmaceutical companies and medical stores should have an insight into the best PBM in the market. This will get them the best deals on medicinal drugs and ensure that they are satisfied with their medications.

 What is a Pharmacy Benefit Manager responsible for?

 A well-renowned has quite a lot of concerns and topics on its plate. As a result, these companies need to take very comprehensive and farsighted decisions to balance medical practices' ecosystem. However, before diving deep into the matter, you should know how a PBM functions and what is the role of PBM.

 As mentioned earlier, a PBM works and functions as the middleman in this ecosystem responsible for signing off deals with several clients at once. Moreover, they also have a responsibility of serving everyone with the proper medication, and thus, maintaining a brand value for such a varied approach may get complicated at times. However, here are the primary aspects which a PBM is responsible for.

 1. Getting the best deals out of pharmaceutical companies. 

As there are tons of various medications in the market that generally focus on a primary issue, finding out the most effective product and a good deal is the first concern that a PBM deals with.

2. Managing the orders and ensuring that the medication is delivered to the patient's address quickly.

3. Distributing the products across several medical houses and pharmacies.

4. Help the patients have a deeper insight into their health plans and all the services that come with them.

 A PBM helps determine the best course of action for both parties