Pharmaceutical manufacturers often give significant rebates to pharmacy benefit managers (PBMs), payers and other entities on brand medications, in exchange for favorable formulary placement and other demand incentives. In 2023, Indiana passed a law requiring health plans to pass manufacturer rebates directly to members in the Affordable Care Act (ACA) individual market at the point of sale beginning in 2025. In this white paper, we study actual 2025 Indiana ACA rate filing submissions to understand whether actual premium changes are consistent with these expectations. We discuss:
- ACA rate filings
- Reported premium impacts
- Prescription drug trends
This report was commissioned by PhRMA.