Radinsky Greg
Kellogg School of Management, USA.
J Health Law. 2003 Spring;36(2):213-46.
Pharmaceutical benefit management companies (PBMs) act as intermediaries between pharmaceutical manufacturers and third-party payors to administer prescription drug benefits. While PBMs have increased in importance in recent years, they have simultaneously become the target of critics, including United States Attorneys and the Federal Trade Commission. This Article gives a brief overview of the federal enforcement environment in which PBMs are conducting business and discusses how PBMs' rebates are negotiated. It then discusses the applicability of the federal Anti-Kickback Statute, which is the likeliest enforcement tool for prosecutors to use against PBMs. The Article concludes by discussing the steps PBMs can take to minimize their liability and provides insight into how effective the federal government will be in building fraud cases against PBMs' current business practices.
药品福利管理公司（PBMs）作为制药商与第三方付款人之间的中介，负责管理处方药福利。近年来，虽然PBMs的重要性日益增加，但它们同时也成为了包括美国检察官和联邦贸易委员会在内的批评对象。本文简要概述了PBMs开展业务的联邦执法环境，并讨论了PBMs回扣的谈判方式。然后，本文讨论了联邦反回扣法规的适用性，这是检察官最有可能用来对付PBMs的执法工具。本文最后讨论了PBMs可以采取哪些措施来尽量减少其责任，并深入探讨了联邦政府在针对PBMs当前商业行为构建欺诈案件方面的有效性。
