https://www.bloomberg.com/opinion/articles/2019-03-01/to-lower-drug-prices-trump-hhs-rightly-targets-pbm-rebates
I went to a meeting where i learned that it is estimated that rebates help insurance companies keep premiums low for their clients, about 1%, which is huge considering the size of that industry.
Even if competitive open or generic insulin reaches the market (wallmart's insulin does not seem to be as godd, isn'tit?), it will not be favored by pharmacy's benefits managers.
Pharmaceutical companies seem to love this reform, probably because it doesn't affect their profit margin which i believe is extremely high already, but i couldn't get a number on this.
Noel