Managed Care Digest Series® Spotlight

Annual Rx Payments Fall Below U.S. All-Payer Avg. for Most Profiled PBMs

Five of the six PBMs shown reported a lower annual payment per all-payer Type 2 diabetes patient receiving long-acting insulin than did the national average in 2020—PBM F excepted ($54 higher).

Meanwhile, annual payments per Type 2 diabetes patient receiving a GLP-1 receptor agonist in the six profiled PBMs were lower than the corresponding U.S. all-payer and PHI benchmarks.

Click here to read the 2021 Commercial Payer Digest.

ANNUAL PAYMENTS PER TYPE 2 DIABETES PATIENT FOR SELECT THERAPIES, BY PAYER, 2020

Data source: IQVIA © 2021

1 Figures reflect the per-patient yearly payments for diabetes patients receiving a particular type of therapy. These are the actual amounts paid by the insurer and patient for such prescriptions. Costs mainly include copayments, but can also include tax, deductibles, and cost differentials where applicable.

2 Private health insurance (PHI) includes employer-based and direct-purchase HMOs, PPOs, point-of-service, and exclusive provider organization plans.

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