Medicare Part D is kind of a cluster fuck. The way the use different PBMs and its your job to create a spreadsheet of all the meds you take, which are covered, and min-max your way to being able to live is absolutely fucking infuriating…

That said, the system absolutely does not push your towards expensive name-brand meds, probably errs on the side of pushing you towards generics, when they are available.

There are other factors on the pharmacy side, including public advertising, so patients demand those name brand drugs, and physician influencing campaigns…