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The White House wants to give prescription drug discounts directly to the consumer. How would it work?




A person pours prescription pills into their hand
A person pours prescription pills into their hand
frankieleon via Flickr Creative Commons

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The head of Health and Human Services, Alex Azar is pushing congress to pass a prescription drug discount plan for both medicare recipients and the privately insured.

Advocates say passing rebates to patients means more consumers savings. Critics which include drug and insurance companies say the plan will increase insurance premiums.

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.

Guests:

Michelle Mello, professor of law and health research at Stanford University; she tweets @MichelleM_Mello

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.

Kristine Grow, Senior vice president of communications for America’s Health Insurance Plans (A-HIP)

Geoffrey Joycedirector of USC’s Schaeffer Center for Health Policy; chair of the Department of Pharmaceutical and Health Economics; professor at the USC School of Pharmacy