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In a recent audit conducted in Mississippi, the findings were nothing short of alarming—PBM-affiliated pharmacies were reimbursed up to 22 times more than independent pharmacies. This type of price manipulation is exactly why PBMs steer patients towards their mail-order and affiliated pharmacies, but they hide this behind the illusion of "low copays."
The Low Copay Trap
PBMs often present low copays to make it seem like you're saving money, but the truth is, they’re marking up the total cost of the medication to shocking levels. According to the audit, generic Omeprazole (Prilosec) was reimbursed at 2,250% of the lowest payment to PBM-affiliated pharmacies, while independent pharmacies were paid the least. This isn’t an isolated incident either. Other drugs, like generic Azithromycin (Z-Pak), saw similar discrepancies.
So, even though you might feel like you’re getting a good deal with a lower copay, PBMs are charging your insurance payer a massively inflated price. In the end, we all pay for it. Those higher prices lead to increased insurance premiums and higher overall healthcare costs.
Overpaying for Prescriptions = Higher Healthcare Costs
This kind of price gouging has long-term effects on the healthcare system. Every time a PBM-affiliated pharmacy overcharges, insurance payers have to adjust, and that means higher premiums for everyone. Patients are unknowingly getting funneled into overpriced prescriptions, believing they’re saving money with a low copay, but what they’re really doing is helping drive up healthcare costs across the board.
Think of it this way: the low copay is just a distraction. While you pay less upfront, the inflated reimbursement rates eventually catch up to you in the form of rising premiums and out-of-pocket expenses.
There’s a Better Way: Fair & Transparent Pricing
At Forest Park Pharmacy, we’re flipping the script. Our cost-plus pricing model means fair, transparent prices every time. No games, no hidden fees, no markups designed to trick you into thinking you’re saving money. We charge a small, fixed margin over the cost of the medication itself, and you know exactly what you’re paying for.
Instead of feeding into a system that’s built on price manipulation and hidden profits, our pricing model provides real savings—for you, your employer, and the healthcare system as a whole.
