Cigna’s Rebate-Free Model Sounds Nice, But Experts Are Still Skeptical

As lawmakers eye tougher oversight of pharmacy benefit managers, PBMs seem to be taking their own steps to rein in practices that have invited scrutiny. However, experts remain skeptical and say it won’t be enough.

The latest example comes from Evernorth, the health services division of Cigna that operates Express Scripts, one of the largest PBMs in the country. Last week, the company announced a new “rebate-free” pharmacy benefit model, in which the discounts the PBM negotiates with drug companies will be passed on directly to patients at the pharmacy counter. This compares to the post-purchase rebate model, in which partial refunds for prescriptions are provided to health plans or employers after a drug is dispensed, often on a quarterly basis.

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