Drug Pricing Woes Linger as Medicare Mulls Point-of-Sale Changes

A Medicare proposal aimed at lowering out-of-pocket drug costs stops short of requiring that all discounts reach consumers at the pharmacy counter, industry groups say.

The proposed rule (RIN 0938–AU30) mandates that Medicare Part D plans apply all “price concessions” they receive from pharmacies to the final sale price. But it wouldn’t ensure the rebates that manufacturers pay to insurers and pharmacy middlemen also apply at the point of sale. Critics argue those rebates are shrouded in secrecy and have ultimately led to higher initial list prices.

Manufacturer rebates “artificially increase the negotiated price of drugs in the Medicare program,” ...