Although the pharmaceutical industry argues that wholesale prices do not accurately reflect prescription drug costs, a new study finds that rising wholesale prices have, in fact, led to higher out-of-pocket expenses for roughly half of insured patients.
The analysis examined 79 brand-name medicines from 2015 through 2017 and found that average wholesale prices — also referred to as list prices — increased by 16.7%. At the same time, there was a 5.4% rise in so-called net prices, which are paid by insurers and pharmacy benefit managers after drug makers offer rebates for more favorable insurance coverage.
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The facts regarding this issue are, It doesn’t matter weather the AWP goes up or down, as long as the ratio of wholesale to net goes up the PBM’s have the ability to take more of a vig . Wholesale price is meaningless to everyone except the PBM’s. This is one of the many ways the PBM’s take what they want. Being that there is NO legislation to govern them this fleecing of America will continue! We need to do away with AWP and just pay pharmacies according to what the drug cost them plus a fair professional fee. The PBM’s should get a transaction fee, PERIOD ! Just like Visa/Mastercard. If this ever happens watch drug prices go down! There has to be one legislator out there that has the Kuhuna’s to suggest this model of drug reimbursement.
There is some truth to the statement from the pharma industry association spokesperson. The insurance companies are hardly innocents.
That said, let us shed no tears for the pharma or insurance industries who spend tens of millions buying up politicians to protect their collusion(s.)
Bottom line: consumers have little insight to how prices are negotiated, Medicare still can’t effectively negotiate (wonder why ..hmm) prices to save money and both industries have little interest in saving the end-consumer money.
These data demonstrate a massive failure in pharmacy benefit designs. Drug net prices decline, yet patients’ out-of-pocket costs rise. Patients with deductibles and coinsurance are being overcharged, because they pay full price for drugs that their health plans buy with deep discounts.
The authors blame list prices. However, they somehow neglect to mention the many sensible policy options that would shield patients from overcharging by health plans.