Analysis: States can help patients save nearly $1,000 annually on their medicines

States can enact legislation today requiring insurers and PBMs to share the rebates they negotiate from manufacturers with individual patients.

Reid PorterApril 21, 2022

Analysis: States can help patients save nearly $1,000 annually on their medicines.

According to a new Ipsos/PhRMA poll, most Americans — 82% — agree that lowering out-of-pocket costs for health care should be a top priority for policymakers. A good place to start in lowering these out-of-pocket costs would be passing legislation at the state level to share some of the $236 billion in savings received by insurers and other middlemen like pharmacy benefit managers (PBMs) with patients at the pharmacy counter.

A recent Milliman report, Measuring the Impact of Point of Sale Rebates on the Commercial Health Insurance Market, analyzed existing rebates negotiated between pharmaceutical companies, health insurers and PBMs in nearly two dozen states. The study found that applying the rebates at the pharmacy counter would likely lead to less than a 1% increase in premiums and could help some patients save nearly $1,000 annually on their medicines.

The bottom line? States can enact legislation today requiring insurers and PBMs to share the rebates they negotiate from manufacturers with individual patients.

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Source: 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

And when you look at the benefits of sharing these savings with patients at the pharmacy counter, it’s a wonder more states haven’t acted.

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Patient examples developed by PhRMA using the results of Milliman’s analysis.

A fact sheet showing the results of the Milliman’s analysis is available here; the other fact sheets detailing state-specific information for the nearly two dozen covered in the report are also included. The full Milliman analysis containing information on the benefits of applying all manufacturer rebates at the point of sale is available on Milliman’s website.

To learn more about how patients can pay less for their medicines, visit PhRMA.org/patients-pay-less.

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