Average Manufacturer Price Cap Update
November 17, 2023
Recently, three pharmaceutical manufacturers announced significant pricing changes to their insulin products in response to regulatory and industry factors stemming from implementation of the American Rescue Plan Act of 2021, along with changes made to eliminate the Medicaid Rebate Cap starting January 1, 2024. While this change will result in a price decrease for these products to members, manufacturer rebates to the health plan will also decrease, or be eliminated. However, the pricing change will also result in a similar decrease in the cost of claims to the plan.