1. Pink Sheet
  2. >>Market Access

PBM Rebates Drive List-To-Net Price Gap For Insulins, Study Shows; More Fodder For Reforms?

 
• By Cathy Kelly

Mandatory government discounts had a much smaller impact on net prices than voluntary rebates in commercial and Medicare Part D plans, researchers determine. The cap on Medicaid rebates, which will be eliminated in 2024, may have contributed to at least some of the disparity.

Study Plumbs Relative Impact Of Price Concessions • Source: Shutterstock

The growth in pharmacy benefit manager-negotiated rebates in Medicare Part D and commercial plans for leading insulin products in recent years underscores how much those concessions have influenced list price increases relative to government-mandated discounts and rebates, according to a new analysis published in JAMA Network Open.

The insulin category is an often-cited example of the disconnect between list and net prices in competitive and highly-rebated categories. (See box, below.)The study attempts to tease out the relative...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required
Start Free Trial

Already a subscriber?

More from Market Access

GLP-1 Pricing ‘Paradigm Shift’ Possible, But Would It Meet Trump’s MFN Goals?

 
• By Cathy Kelly

For the Trump Administration, the blockbuster GLP-1 drugs for obesity have become a poster child for the disparity between US and foreign prices.

Japan Price Cuts For Epkinly and Lunsumio Following CEA

 
• By Lisa Takagi

Japan is cutting more drug reimbursement prices following cost effectiveness analysis and is applying the methodology to a new group of products including Wegovy and Leqembi.

Rocky Rollout Spells Trouble for Medicare Prescription Payment Plan

 
• By Lauren Flynn Kelly

Enrollment in the new Medicare Prescription Payment Plan was lower than expected in the first year and well below CMS expectations, and invoicing data indicates members are slow to pay.

PBM Investigation, Enforcement Action ‘Critical Priorities’ At FTC, Chair Says

 
• By Cathy Kelly

The new FTC chair addressed concerns that staffing cuts will undermine the commission’s commitment to pharmacy benefit manager oversight.

More from Pink Sheet

How Pharma Companies Can Mitigate The Impact Of US Tariffs On The Supply Chain

 
• By Ewan Townsend

If US tariffs on pharmaceutical supply chain products come into force they could be disruptive for companies. Ewan Townsend, of the international law firm Arnold & Porter, explains how companies can mitigate issues through negotiating with suppliers and reallocating tariff responsibilities.

‘The Question Is, What’s Going To Happen Next?’ – The Future For Biosimilars In Europe

 
• By Dave Wallace

With European biosimilars developers buoyed by recent regulatory moves, Medicines for Europe’s Isabell Remus and Julie Maréchal-Jamil discuss the next steps forward for the industry.