Over the past decade, PBMs have been cutting the reimbursements pharmacies receive for the medicine they dispense to insured patients into smaller and smaller amounts. In many places, those reimbursements don’t fully cover the acquisition cost of medicine.

Pharmacies now routinely dispense medication that they lose money on. This is by design. A pharmacist sent us the 2024 contract for a major PBM and it shows that dispensing brand name medicines is compensated at a rate of “average wholesale price minus 25.5%.”

This situation has created a demand for pharmacies to seek vendors who will sell them medicine at a discount, and an opportunity for criminals to enter the legitimate supply chain if they're clever enough to pose as real wholesalers. We asked pharmacists to share their receipts with PSM to show both what they paid for a medicine from their distributor and how the PBM reimbursed them. We found that PSMs are reimbursing pharmacies for less than the cost of medicines, which makes pharmacy buyers trying to keep their businesses afloat perfect targets for criminal counterfeiters trafficking diverted and counterfeit medicine.

Learn more in our longer blog post at https://www.safemedicines.org/2024/02/pbmblackmarket.html.

On January 31, the Department of Justice (DOJ) announced that eBay had agreed to pay $59 million to settle allegations it had not followed recordkeeping and reporting requirements for the sale of pill presses and encapsulating machines that are specified in the Controlled Substances Act. The $59 million settlement is a signal to other online marketplaces that the federal government will not tolerate the unregulated sale of pill presses. The ecommerce company — which has made progressive changes in recent years to prevent pill-making equipment from being listed on their site — has admitted no wrongdoing.

Why did more than 100 children across the country with treatable cancer suddenly spike high fevers? Some fell into comas. Four died. Learn more about this mystery in Colombia.

Senator Mike Braun, the ranking member on the Senate Special Committee on Aging released a report examining the four-fold increase in overdose deaths among Americans 65 and older over the last 20 years. The report recommended increased research into the problem, as well as specific outreach educating seniors about counterfeit medicines made with fentanyl. 

A Chicago, Illinois man with diabetes had a seizure and went into a coma after injecting himself with an Ozempic pen that turned out to be a counterfeit filled with insulin. 

Hernandez sold millions in misbranded HIV drugs to U.S. pharmacies. His case illustrates how drug diversion operations work and why they are dangerous. For more information, visit safemedicines.org.