Geee Posted July 10, 2019 Share Posted July 10, 2019 Inside Sources President Trump promised to reduce Americans’ pharmacy bills — and he’s delivering. His administration will soon finalize a rule that restructures the drug supply chain and ensure that tens of billions of dollars of hidden rebates and discounts flow to patients. The rule affects Medicare Part D, the federal prescription drug benefit for 45 million seniors and people with disabilities. Part D isn’t like other entitlement programs. Numerous private insurers compete to sell prescription drug plans to Medicare beneficiaries. The government subsidizes and regulates these plans, but largely lets the private sector take the lead. As a result of this market competition, beneficiaries can choose from dozens of plans, each with different premiums, co-pays and formularies — the lists of medicines covered by insurance plans. Insurers often hire pharmacy benefit managers (PBMs) to design their drug benefits. PBMs decide which drugs to include on formularies and how much patients will have to pay out of pocket. Drug makers offer massive discounts to PBMs to secure a place on formularies. In 2018, pharmaceutical companies offered $166 billion in discounts and rebates, close to triple the $59 billion they offered in 2012. Link to comment Share on other sites More sharing options...
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