Amid national angst over prescription drug pricing, Express Scripts (ESRX), the big pharmacy benefit manager, is touting a new scheme it says will lessen the behind-the-scenes role that rebates play in rising costs.
The idea targets the complicated calculus used by drug makers and pharmacy benefit managers for negotiating formularies, the all-important lists of medicines for preferred insurance coverage. By doing so, Express Scripts argued costs should decline for some consumers, while appeasing critics — including Trump administration officials — who have urged these companies to eliminate their reliance on rebates.
“We’re trying to create new options in the marketplace,” Dr. Steve Miller, the Express Scripts chief medical officer told us. “The problem is that over the past several years, there has been a distortion in pricing. The national formulary (the existing template for setting coverage) uses rebates, but these often don’t make it all the way to the patient.”