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Most patients never realize that the cash price of the drug is cheaper than the co-pay.
大多數病人從來沒有意識到這種藥物的現金價格比購買保險后要便宜。
"There's this whole industry that most people don't know about,"
“大多數人都不知道，”
says Connecticut lawyer Craig Raabe, who represents people accusing two insurance companies and a PBM of defrauding them.
康涅狄格州律師克雷格·拉比說道。克雷格·拉比代表人們指控兩家保險公司和藥品利益管理機構對消費者施行詐騙。
Clawbacks are possible because benefit managers take advantage of an opaque market,
回扣是可能的，因為利益管理機構利用了市場的不透明，
says Susan Hayes, a consultant with Pharmacy Outcomes Specialists in Lake Zurich, Illinois.
蘇珊·海斯——伊利諾伊州蘇黎世湖的藥學成果專家說道。
Only the PBMs know who pays what.
只有藥品利益管理機構知道誰付多少錢。
For their part, benefit managers argue that they actually keep prices low, in part by negotiating rebates from drugmakers.
藥品利益管理機構認為，他們實際上是通過與制藥商商量回扣來保持低價。
That may be true in some cases,
在某些情況下這可能是真的，
but clawbacks have prompted at least 16 lawsuits since October 2016,
但自2016年10月以來，回扣已引發至少16起訴訟。
with accusations that include defrauding patients through racketeering, breach of contract, and violation of insurance laws.
指控包括詐騙病人，違反合同，違反保險法。
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.
美國最大的三家利益管理機構- 藥品福利管理公司（隸屬于聯合健康集團有限公司）， 西維斯公司(隸屬于CVS Health Corp.)和快捷藥方公司。
—process an estimated 70 to 85 percent of all the prescriptions in the country.
全國約70%到85%的處方都是由這三家公司處理的。
A spokesperson for UnitedHealth Group, Inc., the target of a class action lawsuit alleging that OptumRx required network pharmacies to charge excessive fees,
聯合健康集團的發言人遭到群起指控——藥品福利管理公司要求網絡藥店收取過高費用，
said, "We believe these lawsuits are without merit."
發言人表示：“我們認為這些訴訟毫無意義?！?/p>
