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Newly released pharmacy benefit manager (PBM) data show medicine spending is growing at the slowest rate in years. After accounting for discounts and rebates negotiated with biopharmaceutical companies, PBMs report that medicine spending growth in 2017 was in the low single digits or slightly negative.

So where do the discounts go? 

A previous analysis by the Berkeley Research Group found brand biopharmaceutical companies retained just 63 percent of the list price for brand medicines. The rest – nearly 40 percent – is rebated back to insurance companies, PBMs and the government, or retained by other stakeholders in the supply chain. These discounts and rebates create savings of more than $100 billion, but insurers don’t always share these savings with patients who are facing rising out-of-pocket costs when they go to the pharmacy to get their medicine.  

Patients share the costs. They should share the savings. 

Learn more at LetsTalkAboutCost.org.

Holly Campbell

Holly Campbell is former deputy vice president of public affairs at PhRMA focusing on the cost and value of medicines.

Holly Campbell

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New poll: 2 in 3 voters prefer a candidate committed to lowering health insurance premiums

September 18, 2026

What AARP isn’t telling seniors about MFN

August 24, 2026

Policymakers should improve patient access and reject price controls

August 18, 2026

CMS proposal could discourage patient-centered innovation

August 18, 2026

Insurers blame GLP-1s for rising costs. The data tells a different story.

August 14, 2026

The FTC’s PBM enforcement actions gave us a glimpse behind the curtain; it’s time to let the light in.

August 7, 2026

Nearly 1 in 4 patients initially denied access to IRA medicines

August 6, 2026

Medicare Part D at 20: Building on a strong foundation

July 23, 2026

Message to USAging: Providers are raising concerns about coverage barriers

July 22, 2026

New PBM principles don't change the fundamental challenge: Access to lower-cost medicines

July 10, 2026

340B’s reality: A booming business for hospitals, pharmacies and corporate giants

June 25, 2026

Insurers are blaming medicines for premium hikes in Massachusetts. The state's own data suggests otherwise.

June 24, 2026

MFN won’t lower costs when insurers call the shots

May 8, 2026

Guest Blog: How MFN price controls could decide my health care

April 30, 2026

Briefing: Capitol Hill panel on "Healthcare Denial Crisis in America"

April 24, 2026

Survey confirms too many insured Americans face barriers to reliable health care

April 22, 2026

States should avoid repeating the IRA’s price‑setting mistakes 

April 21, 2026

70% DENIED: How insurance denials are delaying and preventing care for millions of Americans

April 14, 2026

Hospitals drive nearly 80% of the U.S. health spending gap

March 25, 2026

Insurers routinely block seniors’ access to medicines in Medicare Part D

March 18, 2026

MFN undermines U.S. biopharmaceutical innovation

February 25, 2026

CMS puts patients and innovation at risk with MFN

February 24, 2026

No hassle, hidden markups or fees: AmericasMedicines.com

February 19, 2026

The Federal Trade Commission (FTC) takes important action to highlight and curb PBM abuses

February 17, 2026

Separating fact from fiction in the medicine supply chain

February 11, 2026

New list of selected drugs highlights growing consequences of government price setting

January 28, 2026

50-state poll says Americans are concerned that hospital markups hurt patients

January 27, 2026

Three things you should know from the insurer CEO congressional hearings

January 26, 2026

Can’t get your medicine? Don’t count on your insurer.

January 15, 2026

Guest blog: Making the most of the Medicare Prescription Payment Plan

December 8, 2025

The IRA’s price setting doesn’t guarantee lower costs or better access

November 17, 2025

Stop, collaborate and re-evaluate: ICER’s pricing report

November 14, 2025

California’s landmark PBM crackdown: A wake-up call for reform

November 13, 2025

Middlemen mark up drug prices and keep discounts meant for you

November 10, 2025

Putting patients first: Breaking down barriers to care

October 28, 2025

Direct purchase programs can lower costs for patients

October 20, 2025

What seniors can expect this open enrollment

October 14, 2025

Part D premiums are going up, while choices are going down

October 8, 2025

PBMs say they want lower priced medicines, so why don’t they cover them?

October 7, 2025

Historic biopharmaceutical investments: A prescription for America’s future

September 29, 2025

Why states struggle to deliver savings: Middlemen and 340B siphon dollars from patients and states

September 15, 2025

Delivering breakthroughs and lower costs for patients

September 8, 2025

PBMs are hiding hurdles to essential care

August 20, 2025

Celebrating 60 Years of Medicare

July 30, 2025

New study: PBMs and commercial insurers are quietly blocking prescription access

July 30, 2025

North Carolina puts patients first with rebate pass-through law

July 29, 2025

PBMs, not patents, are blocking access to lower-cost medicines

July 23, 2025

Medicare patients face higher drug costs, despite IRA promises

July 22, 2025

The hidden cost of 340B: A multi-billion-dollar burden on taxpayers and Medicaid

July 14, 2025

Medicare Part D plans initially denied medicines for more than 70% of patients in four chronic disease areas

June 16, 2025

New “Balance the Scales” campaign highlights why Americans pay more for prescription medicines

May 21, 2025

How the 340B hospital markup program and PBMs drive up costs for U.S. patients

May 16, 2025

Foreign first pricing schemes don’t address why Americans pay more

May 15, 2025

The AHIP premium dollar corrected (again)

May 8, 2025

PBMs launch new ad campaign to block reforms

May 5, 2025

Ensuring access to affordable medicines for patients through Medicaid

April 28, 2025

When middlemen own it all, patients pay the price

April 10, 2025

3 myths critics get wrong about intellectual property

March 28, 2025

New report finds more abuse of 340B program by hospitals and drug middlemen

March 24, 2025

A closer look at how health care consolidation drives up patient costs, creates barriers to care

March 17, 2025

Health care practitioners sound the alarm on middlemen-imposed barriers to patient care, need for policy change

March 13, 2025

Congress Keeps PBMs in the Hot Seat

March 6, 2025

CMS, don’t fall behind the rest of the medical community on obesity

February 14, 2025

The real cost of denying access to medicines in Medicaid

February 12, 2025

Patients are losing as government price setting continues

January 17, 2025

Wrapping up the J.P. Morgan Healthcare Conference

January 16, 2025

FTC finds PBMs make billions in profit from marking up cancer, other critical generic drugs

January 14, 2025

PhRMA CEOs Tee Up Next Week's Health Care Conference

January 11, 2025

New study: Entities that don’t make medicines get half of what is spent on those medicines

January 7, 2025

A new administration poses new opportunities for patient access

December 17, 2024

Three things to know about 340B contract pharmacies

November 12, 2024

The PBM industry's desperate attempt to stop reform

November 12, 2024

PhRMA launches new ad calling for Congress to make sure savings go to patients, not PBMs

November 11, 2024

Reimagining patient access through meaningful policy reform

November 5, 2024

CMS needs to do better

November 4, 2024

ICYMI: Grounding policy reforms in real lived patient experiences is key to improving outcomes

October 31, 2024

New PES survey: Out-of-pocket costs lead key health care priorities ahead of the November election

October 30, 2024

Guest Post: My health care vote

October 29, 2024

Insurers continue shifting more costs on to patients

October 28, 2024

Americans speak out on health insurance barriers and need for policy change, according to the latest Patient Experience Survey

October 28, 2024

ICYMI: The powerful companies driving local drugstores out of business

October 25, 2024

Is CMS paying attention to the growing access barriers for Medicare patients under the IRA?

October 18, 2024

Did the administration consider the importance of blood cancer medicines to patients in price setting process?

October 8, 2024

Hispanic Heritage Month: Fighting for Hispanic patients

October 7, 2024

Did the administration consider the importance of blood clot medicines to patients in the price setting process?

September 25, 2024

PBMs and insurers off the hook: Sen. Sanders’ selective hearing on drug costs

September 24, 2024

The Inflation Reduction Act could increase costs and reduce access for millions of seniors

September 17, 2024

Are the IRA’s Part B inflation rebates lowering costs for Medicare patients? No.

September 16, 2024

Key voter insights two months from Election Day

September 10, 2024

Patient priorities in the 2024 election

September 10, 2024

Did the administration consider the value of innovative diabetes medicines in price setting process?

August 28, 2024

New survey: Insurers confirm IRA will reduce patient treatment options

August 20, 2024

The unintended consequences of government price setting in Medicare Part D

August 16, 2024

Don’t put the government between patients and their medicines

August 7, 2024

What is the low-income subsidy program and how is it changing?

July 31, 2024

Medicaid by the numbers

July 30, 2024

Voters across all 50 states want state policymakers to focus on health insurance and PBM practices

July 30, 2024

Case study: How seniors could face access disruptions because of the IRA’s price setting provisions

July 22, 2024

WTAS: Voters voice concerns about PBM abuses, call on policymakers to act

July 19, 2024

PhRMA launches new ad in campaign exposing ways middlemen drive up costs

July 17, 2024

FTC report confirms PBMs profit at the expense of patients

July 10, 2024

New 50-state poll Americans want to hold health insurers and PBMs accountable for high out-of-pocket costs and other practices

July 9, 2024

PhRMA reiterates concerns with IRA price setting program, urges CMS to mitigate harm

July 3, 2024

ICYMI: Hidden markups at mail-order pharmacies increase costs for employers

July 2, 2024

The IRA could lead to higher out-of-pocket costs for 3.5 million Medicare patients in 2026

June 25, 2024

ICYMI: What patients care about this election year

June 24, 2024

ICYMI: The Opaque Industry Secretly Inflating Prices for Prescription Drugs

June 21, 2024

ICYMI: Health care policy should be driven by patients, not politics

June 10, 2024

PhRMA Warns Federal Agencies: Consolidation and vertical integration among insurers, PBMs, and hospitals threaten patients

June 5, 2024

ICYMI: Innovation transforms lives but misguided federal policies threaten patient outcomes

May 30, 2024

Ongoing federal probes shed light on PBM and insurer practices

May 20, 2024

Critics repeat same, misleading narrative on potential “costs” of new medicines

May 7, 2024

WTAS: The consequences of consolidation and vertical integration

May 6, 2024

Providing affordable access to medicines in Medicaid

April 30, 2024

IRA is already negatively impacting access to medicines in Part D

April 25, 2024

Insurance data: PBM reform has no material impact on premiums

April 24, 2024

New study finds insurers and PBMs increasing access restrictions in Medicare Part D

April 16, 2024

What recent rhetoric on the cost of diabetes and anti-obesity medicines gets wrong

April 9, 2024

3 Takeaways from POLITICO’s Health Care Summit

April 3, 2024

PBMs using 340B program to drive profits at patients’ expense

March 28, 2024

Four years later, Maryland board still hasn’t delivered for patients

February 12, 2024

Setting the Record Straight: Comparing U.S. drug prices to those in foreign countries hurts patients

February 7, 2024

As the administration continues to falsely claim Medicare “negotiation,” keep these points in mind

February 1, 2024

When it comes to the future of innovation, the ball is in policymakers’ court

January 22, 2024

How the 340B program became a PBM giveaway

December 11, 2023

ICYMI: When middlemen get in the way, it’s the patients who lose

December 5, 2023

Get the facts on PCMA’s newest attempt to avoid accountability

December 4, 2023

Increased use of prior authorization in Medicaid is blocking access for patients

November 28, 2023

ICYMI: WSJ — Same Drug, Two Prices: Why the Higher Price Prevails

November 15, 2023

ICYMI: 3 takeaways on the IRA’s unintended consequences from America’s Physician Groups’ 2023 annual fall conference

November 6, 2023

One year to Election Day: Four voter priorities to watch

November 6, 2023

ICYMI: Scott LaGanga and Matt Salo deliver a State of the Industry Report

October 25, 2023

New poll shows strong bipartisan support for PBM reform

October 20, 2023

4 truths about state government price setting

October 10, 2023

ICYMI: Government watchdog report finds patients in Medicare Part D paid billions more for medicines than insurers and PBMs

September 28, 2023

IRA threatens seniors’ access to robust treatment options

September 26, 2023

Medicare Prescription Payment Plan will benefit patients if implemented correctly

September 21, 2023

New analysis shows PBMs use fees as a profit center

September 18, 2023

It’s PBMs, not patents, blocking competition 

September 14, 2023

Correcting the record: IRA’s government price setting provisions are unconstitutional

September 8, 2023

New PhRMA ad exposes yet another way PBMs get between patients and their medicines

September 5, 2023

IRA changes to Part D risk access to medicines

August 24, 2023

With the first list of medicines out, let’s not forget why government price setting is bad policy

August 22, 2023

One year later IRAs unintended consequences are becoming reality

August 16, 2023

AARP’s latest misleading report

August 11, 2023

Manufacturers provided $42 billion in Medicaid discounts in 2021 alone

August 10, 2023

New report: Hospitals mark up medicine prices 500%

August 2, 2023

read more

August 2, 2023

CMS should rethink proposed changes to the Medicaid Drug Rebate Program | PhRMA

August 1, 2023

Navigating the Patient Experience Survey: Protecting Lifelines to Access and Innovation

July 26, 2023

Three things to know from the latest Patient Experience Survey

July 20, 2023

Key considerations as Congress works towards PAHPA reauthorization

July 12, 2023

Four things for CMS to keep in mind as they implement changes to Part D

June 7, 2023

ICYMI: PBM exec admits choosing profits over patients

June 2, 2023

New calculator demonstrates how improved adherence to anti-diabetic medicines can benefit people in Medicaid

May 25, 2023

Insulin: Key Facts on Access & Affordability

May 10, 2023

4 key facts on medicine prices and spending

May 9, 2023

4 Things to know about PhRMA’s new 50-state poll

May 4, 2023

Americans want state policymakers to lower out-of-pocket costs

May 1, 2023

New PhRMA ad campaign sheds light on PBM abuses

May 1, 2023

Three facts about health care spending

April 25, 2023

AHIP’s latest misinformation campaign & what it’s trying to hide

April 24, 2023

CMS guidance on IRA price setting process doubles down on bad policy

April 14, 2023

A guide to MedPAC’s Part B vote today

April 13, 2023

ICYMI: PhRMA President and CEO Stephen J. Ubl discusses patient affordability

April 7, 2023

MedPAC proposal threatens access to medicines in Part B

April 6, 2023

States can support access to medicine as COVID-19 Public Health Emergency ends

April 5, 2023

Arkansas puts patients first with new share the savings law

April 4, 2023

CMS coverage policy is detrimental to Alzheimer’s patients

April 4, 2023

How Part B’s ASP system helps control costs for the government and seniors

March 30, 2023

Key Trends: Patient experience data reveal how insurers and middlemen impose barriers in health care

March 29, 2023

Medicare Part B spending in four points

March 28, 2023

Insurer and PBM tactics are shifting higher costs to patients with chronic and complex conditions

March 2, 2023

Holding pharmacy benefit managers accountable

February 23, 2023

Stopping pharmacy benefit managers from “gaming the system”

February 22, 2023

Senate hearing to examine bipartisan reforms to rein in middlemen

February 16, 2023

Minnesota lawmakers are letting PBMs off the hook, and threatening patients’ access to medicines

January 31, 2023

ICYMI: Cancer death rate continues to decline due to treatment advances

January 25, 2023

Novel medicines approved in 2022 offer increased treatment options for patients

January 23, 2023

ICYMI: PhRMA kicks off the year at the 2023 J.P. Morgan Health Care Conference

January 19, 2023

Study finds hepatitis C cure saved Medicaid $15 billion

January 5, 2023

ICYMI: PhRMA COO Lori Reilly speaks about the health care agenda for the next Congress

December 9, 2022

In their own words: Financial barriers exacerbate access challenges for insured Americans

December 8, 2022

Putting Delaware patients first: Protecting Patient Assistance Programs

November 22, 2022

Medicare Part D open enrollment and what recent changes mean for beneficiaries

November 17, 2022

New data show how insurers and middlemen shift Rx costs onto patients

November 16, 2022

In their own words: Insured Americans struggle to navigate complex coverage

October 26, 2022

Many seniors are paying more for Part D medicines than their insurer

October 18, 2022

New comments outline ways to protect patients from health plans and PBMs who profit from patient assistance

October 7, 2022

Busting 3 Myths About Copay Coupons

October 5, 2022

Mental Illness Awareness Week – A time for reflection

October 3, 2022

A key fact the White House is reluctant to admit

September 27, 2022

A key fact the White House is reluctant to admit

September 27, 2022

Navigating the patient experience: Burdens and barriers standing between patients and their care

September 12, 2022

CMS coverage policies restrict patient access to important treatment options for Alzheimer’s disease

September 1, 2022

Making coupons count for patients at the pharmacy counter

August 25, 2022

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