Contact: Center for Improving Value in Healthcare
Email: info@civhc.org
In 2019, health insurance payers submitted drug rebate and concession information for 2016, 2017 and 2018 to the CO APCD for the first time. Analysis of rebate data across all years and all payers shows that nearly $3 billion was collected in prescription drug rebates, representing 26% of total spending. While rebates can reduce overall prescription drug spending for payers, they also contribute to long-term growth in prescription drug spending by incentivizing the use of higher cost specialty and brand name drugs. It is also unclear if these savings for commercial insurance companies are passed on to consumers or to employer purchasers through reductions in premiums or prescription drug costs.
This drug rebate analysis is the first in Colorado to provide prescription drug spending and rebate information across Medicaid, Medicare fee-for-service and Medicare Advantage, and commercial health insurance payers.