Large employers are still dependent on pharmacy benefit management firms, but they are unhappy with the complex rebate system the drug supply middlemen use to manage drug costs and are looking to shake things up.
"The problem you have is that you have a supply chain model ... [that] hasn't kept up with today's reality," said Brian Marcotte, CEO of the National Business Group on Health. He said the rebate system was designed for low-deductible plans.
"You fast-forward to today, when many companies offer high-deductible plans … and rebates are not helping the consumer at the point of sale," he said. As a result, workers are left with high out-of-pocket costs for branded drugs.
While nearly two-thirds of large employers still contract with a dedicated pharmacy benefit management firm to handle their drug costs, they've lost faith with the PBM rebate model, according to a new NBGH survey of large employers who collectively provide coverage for 19 million people.
Three in 4 employers told researchers they don't believe rebates drive down drug costs, while 90 percent say they would welcome an alternative approach to rebates.