Wink News: While Washington wrangles with a replacement for Obamacare, patients across the country continue to battle one of the biggest everyday obstacles to good health care: Rising drug prices.

Prescription drugs account for 10 percent of the $3.2 trillion in overall health care spending, outpacing all other health care services, according to government statistics. Consumers with diabetes, cancer and leukemia are some of the most likely to feel pain at the pharmacy due to recent drug price hikes. The cost of two common types of insulin, for instance, increased 300 percent in the past decade.

On the face of it, pharmaceutical companies take most of the blame. Headline-making price jumps for drugs such as Mylan’s EpiPen and the recent announcements on insulin price increases, have shed new light on drug manufacturers’ addiction to higher prices. But pharmacy benefit managers (PBMs), the firms that manage prescription services for insurers, are also culprits, according to health care advocates and recent research published in JAMA Internal Medicine.

Here’s how it works: Large PBMs such as Express Scripts, CVS Caremark and OptumRx, negotiate with pharma companies for lower prices, discounts and rebates on each prescription filled. In return, the drug companies are included on the PBMs’ formularies, the list of drugs insurance will cover. PBMs claim they pass these savings onto the health plans they work for, which in turn lowers prices for consumers.

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