A new study by GlobalData looked at brand oral antidiabetic drugs (OADs) and found that sharing negotiated rebates with patients in commercial health plans at the pharmacy counter can help lower costs, improve adherence and reduce health disparities. This common-sense solution can help us build a more affordable and equitable health care system and help avoid nearly 700 premature deaths each year.
Middlemen like insurers and pharmacy benefit managers (PBMs) negotiate discounts for medicines, but they don’t always share these savings with patients directly at the pharmacy counter. Middlemen say they use rebates and discounts to lower monthly premiums, but sick patients shouldn’t subsidize costs for the healthy.
By passing through rebates and discounts for these diabetes medicines at the pharmacy, the report showed patients in the commercial market could save an average of more than $500 a year. What’s more, it could help patients take their medicines as prescribed, improving adherence by 9%, on average.
Not only would this lead to better health outcomes and lower costs, but this policy could also improve health equity. Diabetes has a disproportionate impact on communities of color. This study shows that Black and Hispanic Americans could experience the greatest improvements in adherence with this policy. These communities would also see the largest reductions in their overall health care costs, with Black and Hispanic patients incurring 6% and 9% less in combined medical and medicine spending, respectively.
The health care system overall also stands to benefit. Over 10 years, passing through rebates could reduce overall health care spending by $8 billion, including a $1.5 billion reduction in patient out-of-pocket costs.
Patients, especially those managing multiple conditions or with serious conditions like diabetes, support changes in health care coverage that lower out-of-pocket costs. It’s time for Congress to pass patient-centered solutions like sharing the savings. Doing so can improve health equity and patient affordability.
To learn more about policies that can help improve the health care system, visit www.phrma.org/BetterWay.