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New data show how sharing negotiated discounts could save certain patients hundreds of dollars at the pharmacy counter

Tiffany Haverly
Tiffany Haverly February 25, 2019

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Updated 3/5/2019

Ensuring patients receive already negotiated savings on their medicines could save certain patients across seven states up to $2,360 a year, according to new analyses from Milliman.

Some patients may see their annual out-of-pocket spending reduced, while other patients may see a monthly reduction in pharmacy costs until they meet their plan out of pocket maximum. All plan members could see a minimal increase in premium, as noted in the table below.

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According to SSR Health, on average, biopharmaceutical companies give back 40 percent of the list price of medicines as rebates, discounts, or other price concessions to insurance companies, the government, pharmacy benefit managers and other entities in the supply chain in order for a medicine to be covered. These rebates and discounts exceeded $166 billion in 2018 alone and are growing every year. However, patients picking up their medicine at the pharmacy counter often do not benefit from these rebates and discounts.

The Milliman analysis builds on a previous study that shows nationwide, sharing negotiated discounts could save certain commercially insured patients with high deductibles and coinsurance $145 to $800 annually and would increase premiums about 1 percent or less.

To learn more, visit LetsTalkAboutCost.org. For individual state reports and fact sheets, click the links below.

CO

MI

OH

NH

NV

SC

WA

Topics: Let's Talk About Cost