In the news, as presented by Medscape.com: About one third of drug spending in the United States goes to pharmacies, pharmacy benefit managers (PBMs), and hospitals or clinics that dispense drugs, according to an analysis published by Health Affairs.

US healthcare spending is a critical economic and political issue, with skyrocketing drug costs reaching crisis levels. Nancy Yu, BA, MBA, a biopharma industry analyst from the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York City, and colleagues estimate that the United States spent $480 billion on drugs in 2016, including the profits of pharmacies and other intermediaries. That is nearly 50% higher than the Centers for Medicare & Medicare Services’ 2016 estimate of $328 billion in US drug spending, which did not include drugs dispensed in hospitals or clinics. The authors note that  “…supply chain intermediaries, or ‘middlemen,’ are capturing much of the money that is often categorized as drug spending.” Yu and colleagues crunched the numbers and found these intermediaries account for about one third of the spending.