In this cross-sectional study, we found that increases in drug wholesale list prices are associated with increases in net patient out-of-pocket costs and insurer payments. This finding suggests that, although discounts and rebates significantly reduce the amount paid for drugs and have increased over the past several years, they have not prevented an inflation-adjusted rise in patients’ and insurers’ costs. This could have both important clinical implications for patient outcomes and an impact on total health care expenditures.

In this analysis of 14.4 million pharmacy claims made by 1.8 million patients from 2010-2016, median drug wholesale list price increased by 129% (interquartile range [IQR], 78%-133%), while median insurance payments increased by 64% (IQR, 28%-120%) and out-of-pocket costs increased by 53% (IQR, 42%-82%).

Among all study drugs that retained patent protection from 2010 to 2014, every $1 increase in AWP was associated with a median increase in patient out-of-pocket costs of $0.04 (range, $0.01-$0.19)

Read More