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Amid ongoing debate over the cost of prescription medicines, a new analysis finds that brand-name drug makers increased their wholesale prices by 5% in the fourth quarter last year, up from 4.3% a year earlier and 4.9% in the previous quarter. But when accounting for inflation, wholesale prices fell by 3%, although further changes this year are likely to more closely mirror inflation.

At the same time, net prices health plans paid for medicines — after subtracting rebates, discounts, and fees — dropped by 0.4%. But again, after considering inflation, net prices actually fell 8.5%, compared with 8.2% in the third quarter of 2022. This was the largest quarterly decline in real terms seen by SSR Health, a research firm that tracks the pharmaceutical industry and conducted the new analysis.


Overall, 82% of medicines experienced declines in wholesale prices in real terms, down from 88% in the fourth quarter of 2021. This was also down from 90% in last year’s third quarter. Meanwhile, the so-called gross-to-net bubble — which measures the gap between gross sales at list prices and net prices after rebates — was nearly 50%, up 2% from a year ago and the largest such increase seen by the analysts.

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