Summary:
This proposal could usher in the
single-biggest change to how drugs are priced at the pharmacy
counter.
The current drug
pricing system is broken and indefensible. Right now, everybody but
the patient benefits as list prices climb higher and higher.
President Trump has proposed to bring transparency to
the system, end the status quo of kickbacks from drug companies to
middlemen and plans, known in the industry as “rebates”, and
deliver those savings straight to patients and their pocketbooks.
This proposal would be a major step forward in
bringing transparency to an opaque drug market that is currently
built on hidden deals and payments that are not reflected in what
the patient pays at the pharmacy counter. The government
knows that rebates are paid on drugs representing 93% of Part D’s
“non-protected class” spending. Patients need to know how much less
they could be spending on high-cost drugs if these savings went to
them. Incidentally, we’ve proposed via other rulemaking to give
pharmacy benefit managers (PBMs) new tools to get better deals on
“protected class” drugs, including tools specific to prices rising
faster than inflation.
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