Insurers look to pass drug price breaks straight to consumer | Chicago Tribune

Some major health insurers plan to take a little sting out of prescription drug prices by giving customers rebates at the pharmacy counter.

Aetna and UnitedHealthcare both say they will begin passing rebates they get from drugmakers along to some customers starting next year. They could spark a trend: The idea has been championed by President Donald Trump, and it’s something other bill-payers like major employers might consider.

Rebates are a key cog in the largely secretive pricing agreements ironed out between drugmakers and pharmacy benefit managers, the companies that manage prescriptions for insurers and large employers. Rebates have become more common in recent years, and some critics point to them as a factor behind soaring drug costs. Aetna and UnitedHealthcare say they want to make prescription drug pricing more transparent and simplify the process for customers.

Here’s a look at the issue.

WHO GETS REBATES NOW?
Pharmaceutical companies offer rebates to benefits managers as a carrot to get their drugs included in formularies, or lists of covered drugs. These concessions are usually a percentage of the initial price set by the drugmaker, or the list price.

Pharmacy benefit managers typically pass rebates on to the insurers and large employers that hire them. Those clients often use the money to reduce their plan’s spending on drugs or the cost of coverage. Only 4 percent said they passed rebates directly to customers at the point of sale, or when they buy the drug, the Pharmacy Benefit Management Institute found in a 2017 report.

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Insurers look to pass drug price breaks straight to consumer – Chicago Tribune.