While it may be politically popular to blame drug prices for skyrocketing insurance costs, the president's claim doesn't stand up to scrutiny. Most notably, insurers don't pay list prices for the prescription drugs they put in their plan formularies.
They pay a deeply discounted rebate price negotiated by PBMs, which are middlemen between manufacturers and insurers. And these net prices have grown at less than the rate of the Consumer Price Index over recent years on a per capita basis.
Like Trump, health insurance executives also attribute rising health care costs to prescription drug prices. America’s Health Insurance Plans President Marilyn Tavenner and American Hospital Association President Rick Pollack wrote in an op-ed for The Hill: “Unjustified and unaccountable spikes in prescription drug prices are the engine of higher costs.”