Everyone knew that President Trump was going to sign executive orders on drug prices the last week of July. No one expected that among them would be a rule that could force PBMs to pass on to Medicare Part D beneficiaries any discounts from manufacturer rebates and other price concessions. Nothing is really shocking these days, but the resurrection of the rebate reform rule—which had failed to advance down a number of avenues before this—did elicit, in a good way, a “Huh,” from me, the APhA government affairs (GA) team, and a lot of other interested parties.
It was a rare L for PBMs, and it’s a positive sign to see executive branch recognition that PBMs do not make drugs more affordable to patients—yet it’s not quite a W for us. Now, our job is to work with the U.S. Department of Health and Human Services (HHS) and our pharmacy partners to ensure the agencies implementing the rebate rule also end PBMs’ gaming of Medicare regulation loopholes, inflating patients' prescription-drug costs, and forcing more pharmacies to close due to the egregious direct and indirect remuneration (DIR) fees they impose and collect for their own profit.