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James B. Rebitzer, Wexler Professor of Management, Economics and Public Policy, Boston University

What are pharmacy benefit managers? A health economist explains how lack of competition drives up drug prices for everyone

PBMs control which drugs insurers cover, for how much and for whom. cagkansayin/iStock via Getty Images Plus

Wegovy and Ozempic are weight loss drugs that promise to transform the treatment of obesity, heart disease and other chronic conditions that afflict millions of Americans. But while everyone agrees these drugs have the potential to transform lives, no one can agree on how best to pay for them.

Wegovy sells for a list price – or price before discounts – of $1,349 per month in the U.S. The same drug lists for $265 in Canada and less than half of that in the U.K. These dramatic differences illustrate a larger issue: The list price of patented drugs in the U.S. are far higher than in other rich countries.

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