Insurance Giant UnitedHealthcare Will Require All New Employer-Sponsored Health Plans To Pass Drug Discounts To Consumers
Pharmacy benefit managers typically negotiate rebates from pharmaceutical companies to help offset the high initial prices set for many drugs. But those discounts rarely flow directly to consumers. The rebate system has come under intense scrutiny as of late as lawmakers take aim at high drug prices and pharma companies point the blame elsewhere. Meanwhile, the Senate Finance Committee plans to call executives from five pharmacy benefit managers--the middlemen who operate within the rebate system--to testify in front of Congress next month.
The New York Times:
UnitedHealthcare Will Expand A Drug Discount Program Aimed At Lowering Consumer Costs
The insurance giant UnitedHealthcare said Tuesday that it will expand a program that passes drug discounts directly to consumers, a move that could lower costs for many who have struggled with high deductible payments and other out-of-pocket expenses. United said the plan would take effect next year and would be required for all new employer clients, although existing clients would be permitted to continue under the older system. Those clients will be “encouraged” to adopt the new plan when their contracts expire, but will not be required to do so, according to Matthew Stearns, a spokesman for OptumRx, the pharmacy benefit manager that is owned by United. (Thomas, 3/12)
The Wall Street Journal:
UnitedHealth To Require Drug Rebates Go To Consumers
The move goes further than other major pharmacy-benefit managers, which haven’t made it mandatory to pass rebates on to consumers, according to UnitedHealth and industry consultants. The Trump administration has proposed a parallel approach that would affect Medicare and Medicaid plans, which pharmacy-benefit managers have generally opposed. “We’re focused on making sure the value we’re negotiating on behalf of our clients is passed on to the consumer,” said John Prince, chief executive of OptumRx. The move to make the shift mandatory for new clients “is a huge statement to the market,” he said. UnitedHealth officials say the employer-plan situation is different from Medicare, where shifting the rebate treatment could force up premiums significantly. (Wilde Mathews, 3/12)
The Associated Press:
UnitedHealthcare Broadens Direct Drug Rebate Program
UnitedHealthcare said about a year ago that rebates would start shifting directly to the customer filling prescriptions for people covered by employer-sponsored health coverage that is fully insured. That's generally small employers. The insurer said that the initial program lowered drug costs by an average of $130 per prescription. UnitedHealthcare said Tuesday that its expanded requirement does not apply to existing employer customers that do not already give rebates directly to the consumer. (3/12)
Stat:
UnitedHealth Will Require Drug Rebates To Be Paid To Consumers
Earlier this year, though, UnitedHealth took a similar step and began passing along rebates directly to consumers under certain employer health plans that are offered by its insurance unit. The insurer estimates consumers are saving an average of $130 per prescription. All totaled, the programs run by both the health plan and the PBM will affect more than 9 million people this year. (Silverman, 3/12)
Reuters:
U.S. Congress Invites Pharmacy Benefit Managers To Third Drug Pricing Hearing
The U.S. Senate Finance Committee has invited executives from five pharmacy benefit managers to testify on April 3 on the rising costs of prescription medicines, in Congress's latest effort to question industry officials directly over an issue voters consistently cite as a top concern. Pharmacy benefit managers (PBMs) administer drug benefits for employers and health plans and also run large mail-order pharmacies. Drugmakers say they are under pressure to provide rebates to the handful of PBMs dominating the market to get their products included on preferred coverage lists. (3/12)
Stat:
Senate Finance Committee Leaders Call 5 PBMs To Testify About Drug Prices
The hearing is the latest development in Grassley and Wyden’s ongoing and bipartisan investigation into high drug prices. The pair has already convened two hearings and launched an investigation into insulin pricing, actions that are quickly distinguishing the Senate Finance Committee as Congress’ most active body on the issue. (Florko, 3/12)
In other pharmaceutical news —
The New York Times:
New Generic Blood Pressure Drug Is Approved To Relieve Shortages
The Food and Drug Administration said on Tuesday that it had approved a new generic version of the widely used blood pressure drug Diovan, or valsartan, which has been in short supply following recalls made because of chemical contamination. The new version is being made by Alkem Laboratories Limited, based in Mumbai, India. (Grady, 3/12)
Prescription Drug Watch: For news on rising drug costs, check out our weekly roundup of news coverage and perspectives of the issue.
