Trump Officials Move to Lower Drug Prices by Passing On Rebates to Patients

WASHINGTON — The Trump administration proposed on Thursday to require health insurance companies and middlemen to give consumers the benefit of discounts they get on prescription drugs, a huge change that could substantially lower some patients’ costs but could also have unintended consequences.

Drug makers now pay billions of dollars in rebates to such middlemen to increase the use and sales of their products. Under the proposal, these rebate payments would be viewed as illegal kickbacks, disrupting longstanding arrangements in the pharmaceutical industry.

“This is an incredibly important proposal that could fundamentally change how drugs are priced and paid for at pharmacies,” Alex M. Azar II, the secretary of health and human services, said in an interview. “The current rebate-based system rewards higher list prices, enriches middlemen and drives up patients’ costs.”