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doi: 10.1016/j.medcli.2025.106941

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doi: 10.1016/j.pt.2018.07.011 21 GoldschlagerN.EpsteinA

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That shift in revenue share 14 percentage points over seven years came largely at the expense of independent pharmacies that had no leverage in contract negotiations and no recourse when PBMs imposed direct and indirect remuneration (DIR) fees, retroactive clawbacks that could arrive months after a prescription was filled