Skip to Main Content

WASHINGTON — The Trump administration’s newest drug pricing idea suggests change on a massive scale: it pitches a wholesale transformation of the way millions of Americans pay for drugs, one that could have a ripple effect into nearly every corner of the country’s health care system.

The proposal would effectively eliminate the rebates that drug makers pay insurance companies in Medicare and parts of Medicaid. Manufacturers pay these rebates to secure good placement on an insurer’s formulary, which makes it easier for patients to get those drugs and harder for them to get competitors’. The regulation, if finalized, would make using rebates a violation of federal bribery law. Instead, drug makers could offer discounts that are more directly passed onto consumers.


But exactly who wins or who loses — and how likely it all is to actually come to fruition — is far less clear. Did the Trump administration just drive a stake through the heart of the pharmacy benefit manager industry? Do they really think they can get this done in less than a year? And there must be a loophole, right?

Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!

  • Do you really think these good old boys at the PBM’s are gonna give up those billions they’ve been stealing all these years ? Ok so they’ll charge a fee to the manufacturer , but if the fed’s know that they’re gonna do this why don’t they prevent fees from being charged ? The problem still stems from
    what I’ve been saying all along…. Get rid of AWP as a cost basis !! AWP means nothing yet the PBM’s will still use that number. They should use WAC (wholesale aquisition cost) . This is the price the manufacturer sells their product to the wholesaler. Wholesalers work on a 2-3% margin . This is at least a more realistic pricing model. They really need to address other issues to level the playing field , like PBM’s owning mail order houses and being transparent as to what they pay pharmacies. If I was their client, I would insist on it !!!

Comments are closed.