Part D Rebates: Policy Tweak Would Retain Manufacturer ‘Contributions’
Peter Bach’s new approach to calculating TrOOP cost in Medicare would prevent big savings to manufacturers from point-of-sale rebates.
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Faced with a proposed regulation that aims to eliminate rebates and an upcoming hearing on Capitol Hill, US pharmacy benefit managers including OptumRx are working to validate the concept of rebates when redirected to patients at the point-of-sale.
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.
Low enrollment indicates that beneficiaries have trouble figuring out whether reductions in cost sharing would offset a much higher premium.