AHIP Comments On Proposed Rule Impacting Drug Pricing Rebates

posted by AHIP

on January 31, 2019

WASHINGTON, D.C. – January 31, 2019 – Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), issued this statement following the release of a proposed rule that would dramatically weaken the ability of health insurance providers and their pharmacy benefit manager (PBM) partners to negotiate lower drug prices for patients and beneficiaries in federal programs:

Drug prices are out of control, and we appreciate the Administration for its continued focus on lowering prices.  Patients should never need to choose between paying their bills and getting the medicines they need.

Big Pharma has been working nonstop to deflect attention from outrageously high prices by convincing Americans that health insurance providers and their PBM partners are the problem, acting as so-called ‘middlemen.’  We are not middlemen – we are your bargaining power, working hard to negotiate lower prices with drug makers to save seniors and other patients about 50 percent a year on their prescription drug and related medical costs. If not for health insurance providers and PBMs, drug prices and costs would be far higher. Projections show that over the next decade, we will save consumers and taxpayers more than $650 billion on drug benefit costs.

We cannot achieve those savings if our leverage and negotiating power is weakened through well-intentioned but misguided actions like this proposed rule. Savings from rebates go directly to consumers, resulting in lower premiums and out-of-pocket costs for millions of hardworking Americans.

From the start, the focus on rebates has been a distraction from the real issue – the problem is the price. Manufacturers have complete control over how drug prices are set. Already this year, more than three dozen drug makers have raised their prices on hundreds of medications.

Insurance providers are part of the solution. We believe the Administration should go back to the drawing board and start over with this proposed rule, and instead take actions that will lower drug prices and hold drugmakers accountable for the prices they set.

About AHIP

America’s Health Insurance Plans (AHIP) is the national trade association representing the health insurance community. AHIP’s members provide health and supplemental benefits to millions of Americans through employer-provided coverage, the individual insurance market, and public programs such as Medicare and Medicaid. AHIP advocates for solutions that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality, and innovation. Visit for more information.