Today, insurance companies contract with pharmacy benefit managers, or PBMs to determine the complicated formula for prescription drugs coverage. Drug companies negotiate rebates (or discounts) with PBM’s on certain drugs theoretically lowering the cost of premiums all around. The Trump administration proposes ending this process by making discounts to specific drugs public, lowering the cost for those who take regular medications.
AirTalk reached out to the U.S. Department of Health and Human Services to request someone be made available for comment, but as of the airing of this segment they have not responded to our request. We will update this story if we receive a response. We also contacted Pharmaceutical Research and Manufacturers of America (PhRMA), the main trade group for branded prescription drugs, but they could not make someone available for the interview.
Disclosure: Professor Mello also serves as a consultant to CVS/Caremark, which is a pharmacy benefits manager, and her services will relate to reviewing decisions determining whether or not a drug is cost-effective enough to attain a favored formulary placement and not to the topic at hand.