The tale of two list prices

It was the highest of list prices, it was the lower of list prices…it was the “same” pharmacy.

Some facts:

1. The list price of imatinib 400mg 30 tabs at CVS Pharmacy is $19,136.¹
2. The list price of imatinib 400mg 30 tabs at CVS Pharmacy inside Target is $10,216.²
3. I can buy imatinib 400mg 30 tabs from my wholesaler for $38.95.³
4. Imatinib is considered a specialty drug by most PBMs, and is therefore subject to narrow networks of specialty pharmacies.⁴
5. CVS Pharmacy owns the biggest specialty pharmacy, by revenue.⁵

Some questions:

1. Why does the same company have two different list prices?
2. Which of these list prices does the nation’s largest specialty pharmacy bill their clients at?
3. If the drug only costs $38.95 wholesale, why do nearly all the prescriptions get funneled through the specialty pharmacy?
4. Why TF do payers (employers, government, patients) put up with this?!

Ready for a more transparent approach? Check out what you could be paying here: https://price.blueberrypharmacy.com

p.s. props if you noticed the two Dickens references!

References:

1. As of 11/10/2021 in 15206 ZIP code via GoodRx
2. As of 11/10/2021 in 15206 ZIP code via GoodRx
3. As of 11/10/2021, NABP accredited wholesaler, Aurobindo manufacturer
4. https://www.cvsspecialty.com/content/dam/enterprise/specialty/pdfs/SpecialtyDrugs.pdf
5. https://www.beckershospitalreview.com/pharmacy/top-15-specialty-pharmacies-by-revenue.html