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Rebates Matter. Here’s Why.


While Congress and the Administration, as well as stakeholders across the prescription drug supply chain, examine policy options for addressing high drug prices, Pharmacy Benefit Managers (PBMs) continue to create access to affordable medications for patients. In Medicare, the rebate rule is threatening to unwind PBMs’ ability to lower prescription drug costs. The time is now for Congress to repeal this costly rule.

The Medicare Part D program is a shining example of the success of the PBM industry. Part D plans, which employ PBMs to negotiate with drug manufacturers, compete against other plans for enrollees based on premiums and benefit designs.

Drug manufacturers compete against each other for formulary coverage by negotiating rebates with PBMs. Rebates are the key to PBMs’ success in achieving access to affordable medications for America’s Medicare beneficiaries through the Part D program. The rebate rule, hastily and heavy-handedly finalized without public input by the previous Administration, will significantly increase beneficiary premiums.

The Biden Administration commendably postponed the effective date for the rebate rule until 2023. Despite the delay, uncertainty remains for PBMs and Part D plans as preparations for 2023 will be underway in just a few short months.

The cleanest path forward to avoid severe disruption to Part D, caused by jarring monthly premium increases, is for Congress to quickly repeal the rebate rule outright. To learn more about the importance of rebates, or how PBMs are #OnYourRxSide, click here.

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Pharmacy benefit managers (PBMs) are your advocates in the health care system, working to lower out-of-control prescription drug costs for patients across the country.

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