Do Specialty Drugs Pay Commissions?

In a previous post on this blog we asked our three readers “Do you know, or have any idea, what the commissions (rebates) are on Skyrizi: 1 Ml Risankizumab Rzaa 150 Mg/Ml Auto Injector?”

Dave Belk responded:

Attached is AbbVie’s 2022 financial statement. On page 40 (I go by pdf page) you can see that their total sales were $47.7 billion in the US and $12.3 billion everywhere else for a total revenue of just over $58 billion that year. On the next page (41) you can see that Skyrizi sales were $4.884 billion in the US and $681 million everywhere else.

Jump to page 47 and you can see the rebates: $10.331 billion to Medicare and Medicaid, $12.974 billion to Managed care plans and $12.829 billion in chargebacks for a total of just over $36 billion.

That means that about $94 billion was paid for all of the medications they sold but they gave back about $36 billion of that, or 38% in rebates and chargebacks. How much of that went to Skyrizi sales is hard to tell but, since pharmaceutical rebates and chargebacks aren’t really a thing outside the US, I would guess that about 45% of their US Skyrizi sales income was given back.

That would amount to just over $3.1 billion in rebates and chargebacks on about $7 billion in total sales.


Dr. David Belk, M.D. is a Internal Medicine Specialist in Alameda, CA