PCMA: Congressional Budget Office Score of Medicare Point-of-Sale Rebates Undermines Drugmakers’ Signature Issue

CBO Confirms Point-of-Sale Rebates in Medicare to Increase Spending by around $43 billion

WASHINGTON, May 29, 2018 /PRNewswire-USNewswire/ -- The Pharmaceutical Care Management Association (PCMA) released the following statement today on the Congressional Budget Office’s (CBO) $43 billion score of point-of-sale rebates in Medicare Part D. CBO’s score is the latest in a series of official estimates showing that point-of-sale rebates in Medicare would increase costs for the government and taxpayers.

“CBO’s examination follows analyses by the Centers for Medicare & Medicaid Services (CMS) and the Office of Management and Budget that also found mandated point-of-sale rebates will increase Part D premiums and government costs.

This score strikes the third blow to the drugmakers’ long-running multi-million dollar campaign to shift blame for their own prices onto the health plans and pharmacy benefit managers (PBMs) that negotiate discounts and rebates to reduce costs. For policymakers, this should be a ‘three strikes and you’re out’ moment.

Drugmakers set and raise prices unrelated to the rebates they negotiate with pharmacy benefit managers (PBMs). Many high-priced drugs like Sovaldi, which initially cost $84,000, involved no rebates at all. PBMs have long encouraged manufacturers to offer payers alternative ways to reduce net costs. Simply put, the easiest way to lower costs would be for drug companies to lower their prices.

We look forward to continuing to work with CMS to find ways to improve benefits and reduce costs in the Medicare Part D program.”

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.

CONTACT: Charles Coté: 202-756-5712; or Greg Lopes: 202-756-5713