1. Pink Sheet
  2. >>Market Access

PBM Rebating Practices: How Much Do Employer Plan Sponsors Really Know?

 
• By Cathy Kelly

A National Pharmaceutical Council survey of self-insured employers offers a new perspective on pharmacy benefit manager claims that rebating practices only reflect the decisions made by their clients.

Employers May Need To Rethink Their Approach To PBM Contracting. • Source: Shutterstock

Nearly two-thirds (62.7%) of employers with self-funded pharmacy benefits reported agreements for specialty drugs that include a guaranteed total rebate amount over the course of a contract, according to a national survey by National Pharmaceutical Council researchers.

Key Takeaways

  • Almost 63% of employers offering self-insured pharmacy benefits choose guaranteed rebates in their vendor contracts with PBMs, according to a survey by the National Pharmaceutical Council.

    ...

Not surprisingly, employers with rebate guarantees “ascribed a higher level of importance” to guarantees in the PBM bidding process than employers receiving rebates without a guarantee and those who do...

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

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.

US FDA’s Familiar Drug Pricing To-Do List

 
• By Michael McCaughan

President Trump’s new Executive Order on drug pricing reprises several policy themes from his first administration, including giving the FDA many tasks intended to increase competition in the marketplace.

Why Hympavzi Secured English Funding For Hemophilia B But Not Hemophilia A

 
• By Neena Brizmohun

Pfizer told the Pink Sheet it would work with the health technology assessment institute, NICE, with the hope of making Hympavzi available to patients with hemophilia A via the National Health Service.

More from Pink Sheet

EMA Says Digital Transformation A ‘Fundamental Shift’ In Meeting Regulatory Challenges

 
• By Eliza Slawther

Sponsors can expect faster evaluation processes for key medicines and greater support in mitigating medicines supply shortages this year as part of the European Medicines Agency’s digital transformation overhaul.

EU CHMP Opinions And MAA Updates

 
• By Neena Brizmohun

This is an update of recommendations from the European Medicines Agency's Committee for Medicinal Products for Human Use on the authorization of new medicines in the EU, and updates on EU marketing authorization changes recommended by the CHMP.

HHS Rescinds COVID-19 Vaccine Advice, Usurping US CDC Role

 
• By Sue Sutter

By stepping into the role of the Centers for Disease Control and Advisory Committee on Immunization Practices, HHS Secretary Robert F. Kennedy Jr. is causing further confusion and uncertainty about vaccine policy, experts say.