Global Pharmaceuticals: US Pharma Rebates: 2026 Commercial insights

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Global Pharmaceuticals: US Pharma Rebates: 2026 Commercial insights

Global Research

22 June 2026ab

Global Pharmaceuticals Equities

GlobalUS Pharma Rebates: 2026 Commercial insights

Pharmaceuticals

Matthew Weston, PhD

Rebates are a key component of the US commercial model in Pharma. They are paid by Analyst

pharma to Pharmacy Benefit Managers (PBMs) in exchange for access/formulary matthew.weston@ubs.com

positioning, and following rebate trends can provide key commercial insights. We set +44-20-7567 4055

out our key 2026 conclusions from extensive analysis of US rebate trends across 30+ Michael Yee

global pharma companies representing over $500bn of US net sales and >330 drugs: Analyst

michael.yee@ubs.com

Industry % rebates have plateaued in the last two years. This marks a

+1-305-536 9101

change from the steady increase in % rebates we have seen since we started

collecting data in 2010, with sector gross-to-net (GTN) now at ~50%. The main Dominic Lunn, CFA

Analyst component of this gross-to-net is rebates used to secure PBM access, but

dominic.lunn@ubs.com

discounts to mandatory government programs and chargebacks in the medical

+44-20-7567 3621

benefit channel also make a significant contribution.

Colin White, PhD

Obesity cash channel may distort traditional rebate dynamics going Analyst

forward. Both Novo Nordisk and Eli Lilly are focussing obesity marketing efforts in colin.white@ubs.com

the self pay channel. High discounts off list price are likely to increase overall gross- +44-20-7567 8657

to-net in the near term, however fewer rebates will accrue to PBMs given patient Alek Ebbeling

savings are realised at the point-of-sale. This is likely to reduce payer leverage, Associate Analyst

however the key question is whether higher volumes can offset lower net prices.