UnitedHealth plans drug rebates
Insurer to pass on savings to 7M people, helping high-cost clients.
In a move likely to help people in high-deductible health insurance plans who take expensive, brand-name drugs, the nation’s largest health insurer announced it will pass on rebates on prescription drugs directly to some consumers.
UnitedHealthcare said the policy, which would begin next year, would lower out-of-pocket costs for 7 million people enrolled in fully insured commercial group benefit plans.
Health care policy specialists noted that the effects for individuals covered by those plans would vary, depending on which drugs they take, how big the rebates are and the structure of their health benefit.
“I think this is a great step in the right direction. I think patients — particularly those struggling with very high deductibles and costs associated with prescription drugs or high coinsurance rates associated with very high-price drugs — stand to benefit significantly from this announcement,” said Rena Conti, a health economist at the University of Chicago.
As people have struggled with high prices for drugs, ranging from insulin for diabetes to the lifesaving EpiPen, there has been heightened scrutiny of the complicated mechanics of drug pricing. Drugmakers set the list prices of drugs, but grant secret rebates to pharmacy benefit managers that negotiate on behalf of insurers and employers.
Due to the lack of transparency in the industry, a raging debate has developed over the extent to which those rebates are being passed on to insurers, employers and consumers.
The largest pharmacy benefit manager, Express Scripts Holding, allows clients to share rebates with consumers at the point-ofsale, but has not seen uptake of the plan design.
CVS Caremark, another large pharmacy benefit manager, said that it provides more than 90 percent of the rebates it negotiates to clients.