Abstract
[...]insurers ofen pocket the rebate savings and shortchange physicians for each bio-similar drug they acquire and administer to a patient in their care. If this continues unchecked, it will undermine patient access to these medications. [...]most biosimilars must go through PBM-owned or -afliated spe-cialty pharmacies, many of which have "white-bagging" mandates that require these drugs to be shipped frst to the phar-macy or the patient's home and then to phy-sician ofces rather than just being sent to practices directly for providers to prepare. Te main perverse incentive underly-ing the issue with biosimilars is that PBM compensation is tied to a drug's list price. Because PBMs negotiate a percentage-based price concession of that cost, they stand to proft more on drugs with higher list prices.