读者文摘:你不知道的医药多余消费(2)（在线收听）

Most patients never realize that the cash price of the drug is cheaper than the co-pay.

大多数病人从来没有意识到这种药物的现金价格比购买保险后要便宜。

"There's this whole industry that most people don't know about,"

“大多数人都不知道，”

says Connecticut lawyer Craig Raabe, who represents people accusing two insurance companies and a PBM of defrauding them.

康涅狄格州律师克雷格·拉比说道。克雷格·拉比代表人们指控两家保险公司和药品利益管理机构对消费者施行诈骗。

Clawbacks are possible because benefit managers take advantage of an opaque market,

回扣是可能的，因为利益管理机构利用了市场的不透明，

says Susan Hayes, a consultant with Pharmacy Outcomes Specialists in Lake Zurich, Illinois.

苏珊·海斯——伊利诺伊州苏黎世湖的药学成果专家说道。

Only the PBMs know who pays what.

只有药品利益管理机构知道谁付多少钱。

For their part, benefit managers argue that they actually keep prices low, in part by negotiating rebates from drugmakers.

药品利益管理机构认为，他们实际上是通过与制药商商量回扣来保持低价。

That may be true in some cases,

在某些情况下这可能是真的，

but clawbacks have prompted at least 16 lawsuits since October 2016,

但自2016年10月以来，回扣已引发至少16起诉讼。

with accusations that include defrauding patients through racketeering, breach of contract, and violation of insurance laws.

指控包括诈骗病人，违反合同，违反保险法。

The three largest PBMs in the United States—OptumRx (owned by UnitedHealth Group, Inc.), CVS Caremark (owned by CVS Health Corp.), and Express Scripts Holding Co.

美国最大的三家利益管理机构- 药品福利管理公司（隶属于联合健康集团有限公司）， 西维斯公司(隶属于CVS Health Corp.)和快捷药方公司。

—process an estimated 70 to 85 percent of all the prescriptions in the country.

全国约70%到85%的处方都是由这三家公司处理的。

A spokesperson for UnitedHealth Group, Inc., the target of a class action lawsuit alleging that OptumRx required network pharmacies to charge excessive fees,

联合健康集团的发言人遭到群起指控——药品福利管理公司要求网络药店收取过高费用，

said, "We believe these lawsuits are without merit."

发言人表示：“我们认为这些诉讼毫无意义。”