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WASHINGTON — The Trump administration on Thursday put forth a long-awaited proposal to eliminate certain rebates drug makers pay insurance companies in Medicare, a move it says will ultimately lower prescription drug prices — and one that stands to upend the complicated structure for how drugs are priced in the U.S.

“This proposal has the potential to be the most significant change in how Americans’ drugs are priced at the pharmacy counter, ever, and finally ease the burden of the sticker shock that millions of Americans experience every month for the drugs they need,” health secretary Alex Azar said in a statement.


HHS’ proposal would eliminate a legal provision that allows drug companies and pharmacy benefit managers to negotiate rebates in exchange for making it easier for patients to get access to certain drugs. But the proposal would explicitly allow drug companies and PBMs to negotiate rebates as long as the savings are passed directly to consumers at the pharmacy.

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  • Beware of loop holes and unintended consequences. The PBMs are great at finding work-a-rounds. What was once a rebate from manufacturers will become a “discount” or an “administrative fee”. The PBMs will find a way to get their money back either from the pharmacies or the manufacturers. Government (not just Trumpies as was said) is naive in this area of the drug business.

  • I am not holding my breath. These Trumpies are so naive. They leave the door open for all sorts of workarounds. Like most Trump proposals they fool his base and many others, but nothing really changes for Big Pharma and Big Oil, and Big Everything else. We paid for the research and then we pay again for the fruits of that research.

  • That’s great ! get rid of the ” Drug rebates “(Extortion to put a drug on formulary). How about the price spread between AWP and what the PBM’s charge their customers? or the other ways PBM’s steal money ?
    How can you have a company that owns pharmacies be the gate keeper (the PBM’s) and decide how much they pay themselves and how much they pay independent pharmacies? Until the government sees that this is the root of the high price of drugs , not much will change. Yes they are hiding behind ” The Safe Harbor Act” What a bunch of crap !!!!!!

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