Discussions about the rising price of prescription drugs often overlook the importance of manufacturer rebates and out-of-pocket prices. 

"We found that although retail pharmacy prices increased 9.1% annually, negotiated prices grew by a mere 4.3%, highlighting the importance of rebates in price measurement," according to a new study reported in HealthAffairs.

"Surprisingly, consumer out-of-pocket prices diverged from negotiated prices after 2016, growing 5.8% annually while negotiated prices remained flat. The concern over drug price inflation is more reflective of the rapid increase in consumer out-of-pocket expenses than the stagnated inflation of negotiated prices paid by insurers after 2016."

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