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Communities: Pharmacy Benefit Management

Employment Impact of Proposed Mandatory Part D Drug Rebates

By Douglas Holtz-Eakin, American Action Forum

The President and some members of Congress have proposed requiring that prescription drug manufacturers pay rebates to the federal government for drugs dispensed to Medicaid/Medicare dual-eligible beneficiaries and other low-income seniors through the Medicare Part D program. (The required rebates would be in addition to the manufacturer-paid rebates already in the Part D program due to the market-based negotiations between manufacturers and Part D plans). 

The Office of Management and Budget (OMB) estimates that the President’s proposal will reduce federal outlays by $135 billion over 10 years.  However, the reduced revenue is likely to substantially affect the pharmaceutical industry, and OMB did not provide any estimates of the effect on jobs – somewhat ironic in that the President’s proposal came in the context of his “jobs bill.” 

In this short paper, we take a step toward filling that analysis gap.  In particular, using the historic relationship between revenues and employment, we find that by 2021 the proposal could reduce pharmaceutical and related employment by up to 238,000 jobs.


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