Medicare Part D pharmacy price concessions at the point of sale

In January 2022, the Centers for Medicare and Medicaid Services and Department of Health and Human Services issued a proposed rule that would require pharmacy DIR to be reflected in the negotiated price used at the point of sale for most drugs. The Pharmaceutical Care Management Association requested we estimate the 10-year financial impact to key stakeholders in the Medicare Part D individual market, from 2023 to 2032. We modeled the potential shift of price concessions, and organize our report as follows: 

• Key findings
• Estimated financial impact
• Stakeholder impacts
• Key considerations

This report was commissioned by the Pharmaceutical Care Management Association.