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Patients with deductibles and coinsurance for prescription medicines pay cost-sharing that is based on the undiscounted list price of a medicine, rather than the discounted price negotiated by their health plan or pharmacy benefit manager (PBM). In the commercial market, one in five prescriptions for brand medicines are filled in the deductible or with coinsurance and cost-sharing for these prescriptions accounts for more than half of patients’ total out-of-pocket spending on brand medicines.