# How drug prices work: a must-read **URL:** \ **Category:** Insurance\ **Created:** [May 26, 2017, 4:28am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054 "2017-05-26T04:28:05Z")\ **Posts on this page:** 12\ **Page:** 2
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [May 29, 2017, 1:01am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/21 "2017-05-29T01:01:42Z")
That would solve so many problems… ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [May 29, 2017, 1:02am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/22 "2017-05-29T01:02:32Z")
> [@Sam](#): > > Obamacare I suspect? No, regular work insurance from a US-based, intl multi-billion dollar company. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [May 29, 2017, 1:04am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/23 "2017-05-29T01:04:08Z")
> [@Sam](#): > > My insurance is really awesome… I suspect you are part of a union? These are the last plans in the US that can be called awesome. Soon there will not be any left. ---
**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\ **Post date:** [May 29, 2017, 1:06am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/24 "2017-05-29T01:06:33Z")
@Sam Most policies from large, non unionized companies follow the same structure that @Michel has described. It may be an effect of Obamacare, but it is not Obamacare. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [May 29, 2017, 1:08am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/25 "2017-05-29T01:08:16Z")
Yes it is a union member owned health trust… . $75 max for 3 month supply of any med. Can ask my plan coordinator (a real person) to approve meds outside of the PBMs formulary. Medical deductible of $250/ individual or $500 for whole family and 90% coverage after that at preferred providers (which is entire Cigna and multiplan networks) and if no preferred provider is nearby they’ll approve anyone else individually for preferred payment rate Pretty hard to complain ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [May 29, 2017, 1:09am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/26 "2017-05-29T01:09:18Z")
> [@Sam](#): > > Yes it is a union member owned health trust… Your plan is now a rare example – a great plan. You are not representative though. Wow. Just looking at the numbers you put up – really great. I have not seen these kinds of plans for at least 10 years, probably more. ---
**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\ **Post date:** [May 29, 2017, 1:15am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/27 "2017-05-29T01:15:08Z")
And that was pretty much the plan my company provided up until about two years ago. It was the top tier plan out of the ones they offered, but it was still less expensive than the $1000 deductible $5000 OOP plan that is their top tier plan now. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [May 29, 2017, 1:19am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/28 "2017-05-29T01:19:32Z")
Yeah up until a couple years ago we had two different plans comparable to my own… and neither one them cost us a dime. After the decuctible we had zero out of pocket expenses. Since the ACA though the second plan rose in cost to about $1000/ month out of pocket to maintain it (starting at zero) and the deductible went through the roof so it just wasn’t worth it to be super well insured anymore so we dropped down to my plan alone… and my employer refused to pay the increased cost of my “Cadillac plan” beyond what their other insurance policies increased… so now I effectively have half the insurance at an infinitely higher cost than I had before… And I’m still in a better situation than the vast majority of Americans… I’m still waiting for that $2500 in annual savings for my family of four though that I was promised. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [June 1, 2017, 8:34am UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/29 "2017-06-01T08:34:44Z")
This brand new article in Forbes discusses the role of PBMs – it is not kind to them 🙂 [https://www.forbes.com/sites/realspin/2017/05/26/middlemen-are-not-passing-on-all-drug-discounts-intended-for-patients/#618a9d81516c](https://www.forbes.com/sites/realspin/2017/05/26/middlemen-are-not-passing-on-all-drug-discounts-intended-for-patients/#618a9d81516c) ---
**Author:** ![ClaudnDaye](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/claudndaye/32/5_2.png) [@ClaudnDaye](https://forum.fudiabetes.org/u/ClaudnDaye)\ **Post date:** [June 1, 2017, 5:41pm UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/30 "2017-06-01T17:41:05Z")
> [@Sam](#): > > . $75 max for 3 month supply of any med. Can ask my plan coordinator (a real person) to approve meds outside of the PBMs formulary. This is exactly what we pay, but we’re part of BCBS PPO - I don’t think union??? My deductible and yearly out of pocket are much higher than the quotes you posted, though (but I’ve got a brady-bunch sized family. ---
**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\ **Post date:** [June 1, 2017, 10:43pm UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/31 "2017-06-01T22:43:22Z")
If you want the alternative viewpoint, go to the comments on this article. There is only one, but it’s from ExpressScripts. Take your blood pressure pills before you read it. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [June 2, 2017, 4:32pm UTC](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054/32 "2017-06-02T16:32:44Z")
I could not quite believe what they wrote there. They had the hutzpah to write that they are helping bring prices down. [Previous page](https://forum.fudiabetes.org/t/how-drug-prices-work-a-must-read/1054.md?page=1)