This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from January 2018.
Yesterday, I examined new data showing that employers are receiving an increasing share of the rebate money collected by pharmacy benefit managers. See Employers Are Extracting More of Their Rebate Dollars from PBMs.
The data, from a Pharmacy Benefit Management Institute (PBMI) survey, also documented a troubling reality. Employers acknowledged that they are hoarding rebates rather than sharing the savings with the employees whose prescriptions generated the rebate funds. It’s the first time that I’ve seen such an admission from plan sponsors.
Consider the data below as confirmation of the warped incentives caused by the gross-to-net bubble—the growing spread between a manufacturer’s list price for a drug and the net price. Consider the diabetes example below. Fixing this situation will be more challenging than walking to Mordor. Point-of-sale (POS) rebates may be a good place to start, but employers seem unwilling to part with their precious.
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