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Commercial payers and PBMs who have long operated in information environments where the true net price after rebates was closely guarded by both manufacturers and PBMs now have a public, government-negotiated reference price for the highest-spending drugs

The initial months include the escalation phase where doses are sub-therapeutic, so dramatic early results should not be expected

7 , e010317 (2018)

The reason this matters for the fragmentation thesis is that it shifts the scoreboard

Hepatocyte nuclear factor 4-alpha (HNF4), a transcription factor, controls the expression of hepatic genes and regulates the development of hepatocytes

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