Recent launches by Lilly, Amgen and Gilead suggest list prices may decrease with the HHS proposal to disrupt the rebate system, but not as low as current net prices after rebates, according to pharmacy benefit experts.

Reform "is going to happen,” promised Energy & Commerce Oversight Subcommittee Chair Diana DeGette, suggesting the panel’s next hearing on insulin price reform may be held in July.

Rebate expectations appear to have got in the way of fast uptake for some of the leading pharmacy benefit managers, according to comments by executives at the Senate Finance Committee hearing April 9.

But CMS also advises Medicare Part D plans to develop bids for the 2020 plan year that include rebates, since the final version of the HHS rule eliminating the anti-kickback safe harbor for rebates may not be released in time for the June 3 bid submission deadline. 

New wrinkle on lowering out-of-pocket spending differs from point-of-sale rebates and manufacturer copay assistance cards, the PBM says, and is not expected to increase plan costs.