Radar on Drug Benefits

Study: With High Prices, Rebate Revenue Is Growing for PBMs

  • May 12
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    May 12, 2022

    New research published in JAMA Health Forum found that rebate revenue for PBMs grew between 2015 and 2019 — but that growing rebate revenue was not passed on to patients.

    The research letter’s authors measured both prerebate and postrebate drug costs taken from medical loss ratio (MLR) filings made by plans to CMS. The research sample includes commercial insurance filings from small group, individual and large group health plans across “approximately 2,200 unique health plans” covering 70 million lives.

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    • Peter Johnson

    Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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Lauren Flynn Kelly

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View Lauren Flynn Kelly's Profile

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Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Tim Casey

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Jill Drachenberg

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PBMs/Pharmacy Benefit Managers
Drug Pricing
Drug Rebates
Reimbursement
Specialty Drugs
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