What actually often happens is that drugs priced at $90 get marked up to $200 with the knowledge that insurers will get a $90 price. The rebate system paradoxically creates an incentive system where it is insurers best interests for list prices to increase dramatically and then receive a discount than for the products to be sold at the discounted price in the first place. It’s a broken system and replacing it should help medicines be priced closer to what real people can pay for.
Yes, the $90 was my copay and I got a copay reimbursal from the drug company so my net was $5. The drug company is trying to mask the cost of the drug from the consumer so they can charge the insurer a higher price. The insurer is charging a copay so the patient feels some of the cost.
However disclosing these practices is not enough. The end consumer has no negotiating leverage particularly if they have no insurance. The government or some big organization needs to negotiate the best price for them.
