Follow the Dollar Executive Summary

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A better understanding of the players involved in the pharmaceutical supply chain, and the role each plays in determining what patients ultimately pay for their prescriptions, can help consumers and policymakers find answers to their questions and concerns about affordability and access to medicines. Drawing from published materials and interviews with industry experts, this paper explains the financial flows that occur as brand medicines move through the supply chain for retail, mail-order, and specialty drugs. Illustrative examples are provided for 3 patients: Janet, Scott, and Diane. Because payment terms are determined through confidential negotiations between stakeholders, the terms of individual contracts are highly variable and may differ from these hypothetical examples.