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Amid ongoing debate over the cost of prescription medicines, a new analysis finds that brand-name drugmakers increased their wholesale prices by 4.9% in the second quarter this year, up slightly from 4.4% a year earlier. But when accounting for inflation, wholesale prices fell by 3.7%, and inflationary pressures are likely to push wholesale prices still higher.

At the same time, net prices that health plans paid for medicines — after subtracting rebates, discounts, and fees — dropped by 0.8%. But after considering inflation, net prices actually fell 7.9% compared with 3.8% in this year’s first quarter. This was the largest quarterly decline in real terms seen by analysts at SSR Health, a research firm that tracks the pharmaceutical industry and conducted the new analysis.

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In fact, 97% of publicly traded brand-name drug companies experienced declines in wholesale prices in real terms, with 95% of brand-name medicines affected. Meanwhile, the so-called gross-to-net bubble — which measures the gap between gross sales at list prices and net prices after rebates — was 48.5%, up from 46.8% a year ago, and the largest increase seen by the analysts.

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