UHC Moves to Pass Drug Rebates to Consumers

This week, UnitedHealth Care announced it would start passing back manufacturers’ rebates on prescription drugs directly to consumers at the point of service to help keep their healthcare costs down.  UHC will start with their fully insured book of business and plan to offer this as an option to their self-insured customers.

While we’re pleased to see UHC offering an additional pricing option for employers as they continue to pursue strategies to keep healthcare costs more manageable for their employees, this new approach will present challenges. Today, most employers offer plans that cover approximately 90% of the cost of medications and leverage prescription drug rebates to lower premium equivalent rates and contributions. It’s unclear under this new option how plan sponsors will confirm that the patient and health plan is getting 100% of the value of the rebate; and, more importantly, how to leverage such an option without having to increase premiums to their populations.

With this announcement from UHC, we suspect other vendors will offer similar solutions, particularly as more employers move to HSA-eligible high-deductible health plan designs. The pace at which employers will embrace these pricing model changes is still unknown. Certainly, we’ll be very focused on monitoring the impact such changes will make to vendor’s renewal offers and ensuring appropriate avenues are available to confirm the value of rebates shared with the patient and plan sponsor.

Source: https://www.nytimes.com/2018/03/06/health/unitedhealth-drug-prices.html?smid=tw-nythealth&smtyp=cur

Raymond Brown
by Raymond Brown

North American Clinical Pharmacy Leader, Mercer

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