Drug rebates for insurers are related to higher costs for patients, especially the uninsured.

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Federal agencies that regulate the price of drugs and health insurance are concerned that the industry’s practice of using rebates to reduce drug costs for insurers has led to increases in list prices and out-of-pocket costs. for patients.

Investigate whether patients with or without insurance paid more because of for insurers, researchers led by the University of Washington examined cost and price data for more than 400 brand-name drugs. The study found that bonuses were associated with increases in out-of-pocket costs for patients averaging $ 6 for those with commercial insurance, $ 13 for Medicare patients and $ 39 for uninsured.

“We know that list prices have risen dramatically, as have rebates, but no one has studied the association between rebates and the costs of your pocket,” said the study’s lead author, Kai Yeung, assistant professor affiliated with the CHOICE Institute at the UW School of Pharmacy. “Increases in your out-of-pocket costs are associated with rebates, however, rebates also help keep premium costs low.”

Consequently, said Yeung, who is also an assistant professor at the Kaiser Permanent School of Medicine Bernard J. Tyson, “has not adequately focused on the impact that the pricing mechanism has on the uninsured. , who are the most affected “.

For the study published on June 14 in JAMA network open, the researchers used data on 444 brand-name drugs without generic equivalents from national data sets involving healthcare costs and prices from 2007 to 2018, including the federal survey of the medical expenses group and SSR Health, a which collects and analyzes the prescription data.

Researchers point out that rising costs can affect patients ’health, as higher costs can cause patients to take the medication less often. This, in turn, can lead to greater use of emergencies and hospitalizations. People in their study who were uninsured had poorer health and people on lower incomes were less likely to take medication as prescribed when costs increased.

“In addition,” the researchers wrote, “uninsured individuals were more likely to be part of racial minority groups, amplifying pre-existing disparities in access to health care.”

As a result, the authors suggest that future research and policies should focus on the decoupling list. for what patients pay out of pocket, “especially for people without insurance.”

“Takeaway food is to understand that sales work to reduce the cost of prescription drugs and can reduce premiums, “said co-author Anirban Basu, director of the Stergachis Family’s CHOICE Institute and professor of health economics at the UW School of Pharmacy.” And while it’s not clear how much they reduce premiums, they definitely don’t translate to getting out of pocket for patients who use treatment because of this co-insurance structure and co-payments linked to the list price. “

Stacie Dusetzina, Vanderbilt University School of Medicine, Nashville, Tennessee, is also a co-author. This research was supported in part by funding from the Donaghue Foundation’s Greater Value portfolio.


When drug manufacturers increase the list price of prescription drugs, do they also increase patients ’out-of-pocket costs?


More information:
Kai Yeung et al, Association of Branded Prescription Drug Rebate Size and Costs of the pocket-of-pocket Costs in a National Representative Sample, 2007-2018, JAMA network open (2021). DOI: 10.1001 / jamanetworkopen.2021.13393

Citation: Drug rebates for insurers linked to higher costs for patients, especially uninsured (2021, June 15), recovered on June 15, 2021 at https://medicalxpress.com/news/2021-06 -drug-rebates-tied-higher-patients. html

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