Drug Price Rebates and 340B Changes Impact Pharmacy Manufacturers | Asembia AXS26

Sabrina Aery, founder and principal of Aery Policy & Access Partners, explores how evolving drug pricing regulations, rebates, and federal programs are reshaping strategies for pharmaceutical manufacturers and pharmacies. Speaking from a manufacturer-focused consultancy perspective, Aery explains that for drugs subject to a maximum fair price (MFP), purchasing largely continues as usual, but there is now a critical float period between the acquisition cost and when rebates are received. Currently, rebates on MFP drugs take about 22 days on average, so pharmacies’ wholesaler payment terms (for example, 30-day payment windows) are key to managing cash flow and minimizing financial exposure.

Aery also highlights this dynamic within a broader industry shift away from traditional rebate-heavy models and toward greater pricing and data transparency, often driven by the demands of employers funding health insurance. She emphasizes that while there is clear momentum toward new models—such as direct-to-patient pharmacy solutions—these approaches will likely remain appropriate only for limited patient populations and select therapies, not as a universal solution. Large pharmacy chains are already evolving their offerings to include direct-to-patient options, reflecting how pharmacy channels are adapting to regulatory and market pressures.

From the manufacturer’s vantage point, Aery discusses mounting scrutiny on pharmaceutical pricing and the likelihood of continued regulation, rather than a simple trend toward deregulation. A central concern is how the 340B Drug Pricing Program will evolve amid new gross-to-net pressures and expanded rebate responsibilities. Aery anticipates heightened data transparency requirements and potential 340B reforms aimed at identifying and plugging revenue leakage, ensuring manufacturers are not effectively paying twice on discounted products.

“I think there's an overall push for deregulation where it makes sense, but I still think you're going to see scrutiny, and you're going to see new regulation as well,” Aery said.