OREANDA-NEWS. The risk of public pushback to pharmaceutical pricing has grown sharply as more and more direct healthcare costs are shifted from payors to patients, according to Fitch Ratings. The recent media and political attention focused on Mylan's EpiPen price increases, and the company's swift responses Thursday and Monday, underscores these evolving dynamics at play among payors, patients and drugmakers.

While it seems in recent years that pharmacy benefit managers (PBMs) and health insurers have become more vigilant and aggressive in moderating the growth of drug pricing, patients are becoming increasingly sensitive to pharmaceutical pricing as health insurance plans more frequently expose patients to more direct costs. This is most often accomplished through higher deductibles and co-pays. In its 2015 Employer Health Benefits Survey, the Kaiser Family Foundation found that annual, out-of-pocket costs rose by nearly 230% from 2006-2015 for employer-sponsored plans.

Consequently, the risk of pushback from consumers in the public sphere, instead of being only from payors and PBMs during private negotiations, has grown, as well as the risk of associated reputational damage.