Prescription Drug Rebate Facts and Sources

JAMA Study Examines Whether 340B Drug Discount Program Genuinely Serves Vulnerable Communities

A new study from the Journal of the American Medical Association (JAMA) found that while contract pharmacies participating in the 340B Drug Discount Program dramatically expanded more than 4,000% between 2011-2019, their presence in the low-income communities they are intended to serve has decreased.

DMHC Report Shows Health Plan Profit and Non-Medical Expenses Far Exceed Rx Expenditures

The California Department of Managed Health Care (DMHC) released a report on December 27, 2021 concluding that prescription drug expenditures are nearly the same as they were in 2017. The report was compiled based on health plan reporting mandated by Senate Bill 17 which requires health plans and health insurers that file rate information with the DMHC or the California Department of Insurance to annually report specific information related to the costs of covered prescription drugs.

Department of Managed Health Care – Prescription Drug Cost Transparency Report

This report looks at the impact of the cost of prescription drugs on health plan premiums and compares this data across the reporting years. The DMHC considered the total volume of prescription drugs prescribed by health plans and the total cost paid by health plans for these drugs, on both an aggregate spending level and a per member per month (PMPM) basis and compared the annualized data. The DMHC also analyzed how the 25 most frequently prescribed drugs, the 25 most costly drugs, and the 25 drugs with the highest year-over-year increase in total annual spending impacted health plan premiums over the course of the last four years.

Measuring the Impact of Point of Sale Rebates on the Commercial Health Insurance Market

There has been heightened interest in understanding the dynamics, challenges, and impacts of passing pharmacy rebates directly to members at the point of sale (POS). This report explores how applying rebates in this manner would affect both member premiums and cost sharing for an average member as well as hypothetical patients with selected chronic conditions.

Examining the Factors Driving the Rising Cost of a Century Old Drug

Diabetes is among the most pervasive, deadly, and costly diseases in the United States. According to the Centers for Disease Control and Prevention (CDC), diabetes is the 7th leading cause of death in the U.S. and more than 34 million people in the country live with the disease.