ABSTRACT
Introduction The sources of payment for pharmaceuticals have greatly evolved over the past 40 years. When Congress passed Medicare and Medicaid in 1965, only about 7% of retail expenditures for pharmaceuticals were paid by insurers and public programs, i.e., third-party payers [1]. However, by 2012 the percentage of retail prescription drug payments by third parties had climbed to 81% [2]. This substantial increase has provided third parties with influence over the prescribing, dispensing, and use of prescription drugs. This change has contributed to an ongoing struggle over controlling costs involving employers, government agencies, pharmacy providers, and the pharmaceutical industry.
