Aetna Will Apply Pharmacy Rebates to Prescription Drugs in 2019
Aetna announced plans to automatically apply pharmacy rebates to eligible prescription drugs by 2019.
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By - Aetna has announced plans to automatically apply pharmacy rebates to eligible prescription drug benefits by 2019 in an effort to increase pricing transparency and control costs.
Nearly three million Aetna members are likely to experience lower prescription costs through the rebates.
Aetna stated that most rebates are already passed on to health plan sponsors through lower premiums. However, the organization believes that greater drug price transparency is necessary to address significant increases in drug prices nationwide.
“We have always believed that consumers should benefit from discounts and rebates that we negotiate with drug manufacturers,” said Mark T. Bertolini, Aetna chairman and CEO. “Going forward, we hope this additional transparency will encourage these companies to rationalize their pricing and end the practice of annual double-digit price increases.”
Aetna believes that improving prescription drug prices will involve changes to Medicare Part D, such as implementing the Medicare Payment Advisory Commission (MedPAC) suggestion to put out-of-pocket maximums for drug spending in place.
MedPAC proposed to limit out-of-pocket costs for Medicare members to $5000 a year. The group also suggested a limit on coinsurance amounts to between $3.35 to $8.35 per prescription after a member hits the $5000 amount.
Aetna also supports price transparency by endorsing the elimination of gag clauses.
Gag clauses are policies that prohibit pharmacists from informing consumers when a cash purchase of a drug is cheaper than using their health plan. Aetna stated that it does not endorse or require gag clauses in pharmacy contracts.
The payer’s announcement follows policy discussion between federal leadership, payer organizations, and related stakeholders to provide fairer drug prices and protect consumers from rising prescription drug prices.
A Senate hearing at the end of 2017 proposed several policies to improve prescription drug prices.
Policies Aetna fully supports like capping out-of-pocket spending limits and limiting Part D cost-sharing were among the discussed solutions. Stakeholders additionally suggested other policies like expanding the generic drug market and requiring pharmacy benefit managers to disclose rebate amounts.
Bertolini concluded the announcement by suggesting that new healthcare policies should ultimately hold both payers and drug manufacturers equally accountable for rising prescription drug costs.
“Additional reforms are needed to bring down rising drug prices that are driving increased spending across the healthcare system,” Bertolini said. “Payers are required to spend the vast majority of premium dollars on medical costs, not overhead or profits. Drug manufacturers should be held to the same high standards.”
