InsideSources: JC Scott – Exploring Alternatives to the Prescription Drug Rebate System

"PBMs want lower list prices, not bigger rebates."

In a recent op-ed published in InsideSources' D.C. Journal, JC Scott, president and CEO of the Pharmaceutical Care Management Association (PCMA), argues that pharmacy benefit managers (PBMs) support reforming the prescription drug rebate system to make drugs more affordable for all patients by adding options that improve flexibility in how PBMs negotiate with drug companies. He writes that updating the law "could allow for upfront discounts, which could lead to better ways to lower out-of-pocket costs for patients and a clearer understanding of the discounts for employers and everyone in the system."

Read the Full Op-ed Here

Scott explores reexamining the Robinson-Patman Act to achieve savings that go beyond the current prescription drug rebate system:

"By reexamining Robinson-Patman to allow for upfront discounts on prescription drugs, PBMs can expand the ability to lower drug costs by negotiating for either kind of discount, whichever delivers better savings and lower costs, or is preferred by PBMs' clients (employers, health plans, and government programs). Upfront discounts may help patients enrolled in high-deductible health plans, whose plan design sometimes places the full cost of prescription drugs on them until they reach their deductible."

He continues to explain how reforming the current drug rebate system would also enhance transparency for employers, who currently receive information on prescription drug rebates, pharmacy price concessions, and administrative fees from their PBMs:"Reexamining Robinson-Patman could also provide employers with even more transparency into their drug costs, arming them with the data they need to evaluate spending and make changes that will benefit their employees. PBMs support and practice actionable transparency, enabling employers to make informed decisions on how best to manage their prescription drug costs."

The piece further underscores the PBM industry's commitment to delivering savings and lowering drug costs:

"As the mechanism available today, rebates are an important way to achieve lower drug costs. As we look at changes that allow us to consider a different system, we should make sure to preserve the fundamentals: being able to negotiate discounts makes drug companies lower their costs and delivers savings for employers, unions, taxpayers, and patients."

It's always worth repeating: Rebates are not driving drug prices higher; rebates are not correlated to drug prices.

Read the full op-ed HERE.

Learn how PBMs are innovating to respond to evolving consumer and employer demands HERE.

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PCMA is the national association representing America's pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 289 million patients.