There’s an old joke in economics that whoever invented the idea of “eliminating the middle man” probably wasn’t a middle man.

The insurance companies and their pharmacy (PBM) divisions insist that they add value to drug distribution that justifies their business practice of pocketing rebates using their exemption from the federal Anti-Kickback Statute.

We’re skeptical.

But the best way to find out who’s right in this fight is to open the drug delivery system up to competition by allowing direct-to-consumer sales by manufacturers.  This is now happening, thanks to President Trump persuading manufacturers to start offering blockbuster drugs directly at a 40% discount from list price.

This way, consumers can decide for themselves whether the middleman is necessary.