The Medicare Part D prescription drug benefit provides our nation’s seniors with affordable drug coverage, which is more important now than ever.

The rebate rule clumsily attempts to eliminate the primary tool used by pharmacy benefit managers, or PBMs, to negotiate increased access to affordable prescription drugs with drug manufacturers. The rule would not reduce drug costs: Centers for Medicare and Medicaid Services actuaries and the Congressional Budget Office have said it would significantly increase Medicare Part D premiums and add $170 billion in Part D program costs for taxpayers.

Medicare beneficiaries appreciate the Biden Administration’s decision to delay the prescription drug rebate rule. Congress and the Administration should now permanently repeal the rebate rule and advance real solutions that protect seniors while bringing down the costs of prescription drugs.

Letter to Congress from organizations working to protect seniors and maintain affordable access to prescription drugs

“We believe it is imperative to block implementation of this rule to protect Medicare beneficiaries and taxpayers from unsustainable cost increases.”

read the entire letter from the organizations below

  • Academy of Managed Care Pharmacy
  • America’s Health Insurance Plans
  • Better Medicare Alliance
  • Blue Cross Blue Shield Association
  • Campaign for Sustainable Drug Pricing
  • Coalition for Affordable Prescription Drugs
  • Consumer Action Council for Citizens Against Government Waste
  • Einstein Healthcare Network
  • National Adult Day Services Association
  • National Coalition on Health Care
  • Ohio School Employees Retirement System
  • Pharmaceutical Care Management Association
  • Public Sector HealthCare Roundtable
  • Teachers’ Retirement System of the State of Kentucky
  • Tufts Health Plan

Medicare Premiums Will Increase an Additional $56 Billion Over 10 Years With Adoption of the HHS “Rebate Rule”

WHEN MEDICARE PREMIUMS RISE, BENEFICIARIES IN ALL STATES PAY MORE

Methodology: The Health and Human Services (HHS) Office of the Actuary (OACT) estimated that adoption of the HHS “Rebate Rule” would cause Medicare premiums to rise $56 billion over the 10-year period 2020-2029. That 10-year premium impact was apportioned across the 50 states and the District of Columbia using 2018 Part D enrollment.

Sources:
HHS OACT “Proposed Safe Harbor Regulation.”
Kaiser Family Foundation “Medicare Beneficiaries Enrolled in Part D Coverage (2018).”

Research

State Health Plans Use Drug Rebates to Lower Premiums and Enhance Benefits

Read the results from the new Public Sector Healthcare Roundtable Survey…

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National Online Survey of Seniors Regarding the Medicare Part D Prescription Drug Benefit

In collaboration with North Start Opinion Research, PCMA conducted an online on December 17-20, 2020 with 800 respondents…

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Impact of Medicare Part D Drug Manufacturer Rebates at the Point-of-Sale

A new report by Milliman shows that over the 10-year period 2022-2031, if all manufacturer rebates were reflected at the…

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OP-Eds & Press Releases

Morning Consult: Congress Should Act Quickly to Permanently Repeal the Rebate Rule

April 12, 2021

While Congress and the Biden administration, as well as stakeholders across the prescription drug supply chain, examine policy options for addressing high drug prices, pharmacy benefit managers continue…

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PCMA Launches New Campaign Aimed At Repealing the Medicare Prescription Drug Rebate Rule

March 1, 2021

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) unveiled a new campaign commending the Biden Administration for delaying the Medicare prescription drug rebate rule…

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Rebate Rule Effective Date Postponed to 2023

January 30, 2021

(Washington, D.C.) — In response to litigation brought by the Pharmaceutical Care Management