PBM rebate arrangements

Pharmaceutical manufacturers pay rebates to pharmacy benefit managers and health plans as part of their formulary contracting agreements. The “2010-2011 Prescription Drug Benefit Cost and Plan Design Report” says that rebates are calculated as a guaranteed amount per prescription or an actual amount per prescription. The report says that there has been an increase in rebate amounts over time, excluding this year’s average guaranteed rebate per mail prescription. The report says fewer employers provided rebate data in 2010, which might account for the lower amount reported for guaranteed rebate per mail prescription and actual amount per retail prescription.


Source: Pharmacy Benefit Management Institute. “2010–2011 Prescription Drug Benefit Cost and Plan Design Report.”