Senior diabetic patients can save significant cost if negotiated rebates are shared at pharmacy counter

Sharing a portion of negotiated rebates at the pharmacy counter could save seniors in Medicare with diabetes more than $350 annually, according to a new analysis from IHS Markit. The data also show sharing negotiated rebates could save Medicare nearly $1000 annually for every senior taking diabetes medication and reduce total health care spending by approximately $20 billion over the next ten years.

"Robust competition and choice in Medicare Part D has led to expanded coverage and stable premiums, but more needs to be done to improve affordability and predictability for seniors," said Stephen J. Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), which commissioned the study. "Sharing negotiated rebates would lower out-of-pocket costs for seniors and result in significant savings across the Medicare program."

Diabetes is a common disease among Medicare beneficiaries and yet there continues to be significant underutilization of diabetes medicines. Complications resulting from mismanagement of the disease currently costs the Medicare program nearly $100 billion each year.

According to the new IHS Markit analysis, "for brand diabetes medicines, wide availability of competing products within multiple therapeutic classes has enabled payers to negotiate additional savings, reducing the net prices of some products by more than 70 percent." Currently, most seniors do not see these savings in the prices they pay at the pharmacy counter.

IHS Markit found that sharing 80 percent of these rebates with seniors would lower their out-of-pocket costs by $350 per year and reduce total health care spending by approximately $20 billion over the next ten years due to improved medication adherence and better management of the disease.

The new analysis provides further evidence on the benefits of sharing negotiated savings with patients. Earlier this year, PhRMA submitted comments to the Centers for Medicare and Medicaid Services urging the agency to require Part D plans to pass through negotiated discounts and rebates to beneficiaries at the point of sale. In addition, PhRMA recently launched a new "Let's Talk About Medicare" campaign focused on solutions, like sharing the savings, that would improve affordability and predictability for seniors.