Health Affairs February 1, 2019
Yesterday, the Trump Administration released a proposed rule which aims to eliminate rebates from pharmaceutical companies to pharmacy benefit managers (PBMs) in Medicare Part D and in Medicaid managed care organizations. The proposed rule would eliminate the regulatory safe harbor for rebates as they exist today, replacing it with two far narrower safe harbors designed to directly benefit patients with high out-of-pocket costs and to change the way PBMs are compensated.
If finalized in its current form, this proposed rule would almost certainly be the largest change to the prescription drug pricing system the administration has put forward so far. However, many questions remain about what the effects of the proposed rule would be, and whether the administration’s ambitious implementation...
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