[gruez]

>Of course, this could lead to a bigger problem, because insurance companies could account for programs like this in rates, and now you have an arms race where your policy only makes cost sense if you are getting these incentive payments.

Aren't the two in equilibrium though? The price of the kickback is priced into the MSRP of the drug, and the kickback you get is priced into the cost of the policy. If the kickback disappears, both would cancel out.

[mattnewton]

They are in equilibrium for people buying the product with the kickback. Other brands now are artificially more "expensive" and have to issue kickbacks to remain attractive, or the people who aren't participating just have worse rates because they might accept kickbacks in the future even if they aren't using drugs that offer them today.

My understanding is that your policy funds are effectively "mixed" with other people covered by your insurance company.

So, I think it could very easily be a net transfer of money from people who aren't using that drug category but have insurance policies used by people who do use that drug, to the drug company at the end of the day.