Middlemen that negotiate drug discounts are under fire fromdrugmakers who say that secret rebates aren’t always shared withpatients.

But Express Scripts Holding Co., one of the biggestpharmacy-benefits managers, says the drug-price deals it cutsbehind closed doors are saving consumers a lot of money.

In a new report, the company said U.S. drug costs for itsemployer, union and other commercial plans rose just 1.5 percentlast year, on a per-person basis, the smallest increase in the morethan two decades the company has been measuring it. Costs declinedfor nearly half of its commercial clients, when rebates areincluded.

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