Will Trump’s new drug rebates proposal end PBMs? And 6 other burning questions about the idea
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WASHINGTON — The Trump administration’s newest drug pricing idea suggests change on a massive scale: it pitches a wholesale transformation of the way millions of Americans pay for drugs, one
that could have a ripple effect into nearly every corner of the country’s health care system.
The proposal would effectively eliminate the rebates that drug makers pay insurance companies in Medicare and parts of Medicaid. Manufacturers pay these rebates to secure good placement on
an insurer’s formulary, which makes it easier for patients to get those drugs and harder for them to get competitors’. The regulation, if finalized, would make using rebates a violation of
federal bribery law. Instead, drug makers could offer discounts that are more directly passed onto consumers.
But exactly who wins or who loses — and how likely it all is to actually come to fruition — is far less clear. Did the Trump administration just drive a stake through the heart of the
pharmacy benefit manager industry? Do they really think they can get this done in less than a year? And there must be a loophole, right?