WASHINGTON, Sept. 13, 2019 /PRNewswire/ -- Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the Health and Human Services Officer of Inspector General report (OIG) on prescription drug rebates in Medicare Part D.
"Today's OIG report further dispels the false narrative about PBM-negotiated rebates and confirms that rebates lead to lower prescription drug costs in the Medicare prescription drug program. Drug manufacturers alone set and raise drug prices. As the only check on manufacturers' pricing power, PBMs have been able to achieve an overall stable cost trend for prescription drugs.
OIG's report adds to a growing body of evidence that the PBM-negotiated rebates lower prescription drug costs. A recent GAO report highlights that virtually all of prescription drug rebates negotiated by PBMs with drug manufacturers in Part D are passed through to drug plan sponsors and used to lower costs for Medicare beneficiaries.
We understand that for some people prescription drug costs remain unaffordable. PBMs will continue working with policymakers to advance solutions that encourage greater competition to reduce drug costs for every consumer."
Key findings in the OIG report include:
- Only a small fraction of drugs — 10 percent — accounted for 60 percent of rebate growth between 2011 and 2015.
- Rebates did not go up with increases in total reimbursement: 39.3 percent of rebated brand drugs had reimbursement increases and rebate decreases, while 56.3 percent of rebated brand drugs had reimbursement increases and rebate increases.
- In Part D on brand drugs with rebates, total reimbursement increased 19 percent, while rebate-adjusted reimbursement increased just 4 percent.
PCMA is the national association representing America's pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.
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