The debate about drug prices and the drug channel system will continue in 2018. Let’s shed some light on one murky, little-understood corner of this world: how employer-sponsored health plans access the billions of dollars in manufacturer rebates that are negotiated by their pharmacy benefit managers (PBMs).
We turn to data from the Pharmacy Benefit Management Institute’s (PBMI) excellent 2017 Trends in Drug Benefit Design. (Free download with registration.) As far as I know, it’s the only public data source for understanding PBM-client rebate practices.
According to PBMI’s survey data, larger and smaller employers increasingly receive 100% of manufacturer rebates for traditional drugs. Many have also negotiated guaranteed rebates that shift risk to PBMs. Other employers get a share of the rebates or a flat guaranteed amount.
Below, I delve into the data and offer my observations. Tomorrow, I’ll examine what employers are doing with these rebate dollars. Spoiler alert: It’s usually not good for patients.
Read more »
Source: Post feed
