MUST READ! Our Complex Healthcare System: No Loophole Will Go Undetected by Profit-Seekers by Craig Hasday July 17, 2014--discusses insurance, compounding pharmacies and what PBMs are doing to elimiate the fraud

In 2012, in an effort to promote cost transparency, new regulations were issued requiring pharmacies to list all drugs included in a compounded medicine when seeking reimbursement. Previous protocol required that only the most expensive drug be listed, and reimbursement was based on the cost of that drug. At the same time, drug manufacturers escalated the cost of the bulk powders used in making these compounds. A cottage business of “compounding pharmacies” quickly sprang up, which began charging separately for each drug in the compound and creating compounds where none were needed. This process inflates the costs of these medications to ten or more times their previous level. For one client, compound drugs accounted for 10% of drug spend in the most recent experience period.

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