December 2019

Cigna’s Take: Drug Rebate Proposed Rule

One of the hottest topics today is how to address rising drug costs. At the center of the conversation is how drug rebates are used and whether they should be directly passed on to the consumer at point-of-sale. In February, the Department of Health and Human Services (HHS) issued a proposed rule to remove safe harbor protection for drug rebates in Medicare Part D and Medicaid, unless the rebates are passed through to beneficiaries at point-of-sale. There has also been increasing interest in Congress to legislate similar changes for employer-sponsored coverage.

At Cigna, we believe there is widespread misunderstanding about the role rebates play in improving overall affordability and choice. Rebates are a critical tool to achieve affordability. They are not the cause of, or solution to, high drug prices. Employers currently have the flexibility to use the value of rebates to lower premiums and cost-sharing, expand access, enhance benefits or provide the discounts to enrollees at the point of sale, depending on the needs of their employee population. If the use of rebates was mandated, it would increase costs for the majority of enrollees while providing limited relief to those whose prescriptions carry rebates.

To learn more about our policy position and comments provided to HHS on its proposed rule, click here to read a summary of our response. It outlines the likely impacts of the proposed rule and our desire to work with the agency to advance reforms that we believe will accomplish the goal to make prescription drugs more affordable.