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The most consequential potential change to the drug pricing system – the overhaul of pharmacy benefit manager (PBM) rebates, with attendant 100% pass-through to beneficiaries – won’t happen. The Biden Administration has essentially nixed former President Trump’s executive order calling for a 100% pass-through of rebates. And, PBM rebate reform is not even stipulated in the budget reconciliation bill, or the Build Back Better Act.

Given this growing challenge, pharmacy benefit managers (PBMs) have never been more essential. For both public programs and private insurance, PBMs are actively engaged in keeping prescription drug costs down and making medications more affordable for individual patients.

Simply put, the core mission for PBMs is to be the primary advocate for consumers and health plans in the fight to keep prescription drugs accessible and affordable.

The drug giants moved in near-perfect synchronicity, raising prices for their top-selling arthritis treatments as though they were opposite-corner gas stations bumping up the price of unleaded.

FDA Commissioner Scott Gottlieb calls “patent thickets,” claiming multiple patents for a single drug to build protection from competitors.