The Rebate Effect: ‘Traditional’ Brand Costs Decline 6.5% In Commercial Plans
Lower net costs held overall spending on retail prescription drugs in employer-sponsored insurance to an increase of just 0.4% in 2018, according to the latest Express Scripts Drug Trend Report.
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Pharma is facing a big headwind in 2019 in the form of diminished drug pricing power. The pricing trend puts net drug prices squarely in the red for most large pharma manufacturers, but US lawmakers aren't likely to be reassured heading into an upcoming hearing on drug pricing.
HHS seeks input on how stakeholders might adjust to a system without rebates and requests comments on three actuarial reports that attempt to project the financial impact of the change.
Proposed US rule would establish two new safe harbors against anti-kickback enforcement, one covering price reductions at the point of sale and the other protecting flat service fees paid by manufacturers to pharmacy benefit managers. But rebates to "PBMs to buy formulary position" in Medicare/Medicaid would lose protection.