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The Trump administration believes it is a “right that, when you are sitting there with your doctor, you ought to be able to know what your out-of-pocket [cost] is for drug you are going to be prescribed under your precise drug plan. And you ought to have information on what competing drugs are that your doctor is not prescribing and what you would pay out of pocket for that.”
Price transparency is a key theme to the broad package of proposals called American Patients First that the White House released May 11. The plan includes changes that can be made immediately as well as some upon which the administration will seek public comment, according to the plan.
Another tactic the administration is considering for quick action is requiring a drug’s list prices to be included in all direct-to-consumer advertising.
The plan also calls for the banning of gag rules that prevent pharmacists from alerting patients when it would be cheaper to buy a prescribed drug without going through their insurance coverage, as well as moving certain drugs from Medicare Part B to Medicare Part D to improve the government’s ability to negotiations for lower prices.
The overall strategy is laid out across four areas:
- Increasing competition though policy measures that prevent manufacturers from gaming the patent system and promoting innovation and competition among biologics.
- Improving negotiation abilities, including doing more with value-based purchasing; allowing for more substitution, especially in the case of single-source generics; and further examination of the competitive acquisition program for Part B.
- Providing incentives to manufacturers to lower their list prices.
- Lowering out-of-pocket costs.
Currently, there is no incentive to lower drug prices, Mr. Azar noted. He called out pharmacy benefit managers (PBMs) for financially benefiting from both manufacturers and the insurers they represent and said HHS is looking into banning financial compensation to PBMs from the manufacturers. He also said the agency will be releasing a request for information on the feasibility of doing away with rebates as a means of driving manufacturers to lower their prices.
PhRMA, the lobbying group representing pharmaceutical manufacturers, said in a statement that some of the changes related to Part D “could undermine the existing structure of the program that has successfully held down costs and provided seniors with access to comprehensive prescription drug coverage. We also must avoid changes to Medicare Part B that could raise costs for seniors and limit their access to lifesaving treatments.”
The Pharmaceutical Care Management Association, the lobbying group for pharmacy benefit managers, also spoke out against the idea of eliminating rebates, noting in a statement that getting rid of them “and other price concessions would leave patients and payers, including Medicaid and Medicare, at the mercy of drug manufacturer pricing strategies. PBMs have long encouraged manufacturers to offer payers alternative ways to reduce net costs. Simply put, the easiest way to lower costs would be for drug companies to lower their prices.”
The American Medical Association voiced support for the plan.
“The AMA is pleased the Trump administration is moving forward with its effort to address seemingly arbitrary pricing for prescription drugs,” President David Barbe, MD, said in a statement “Physicians see the impact of skyrocketing prices every day as patients are often unable to afford the most medically appropriate medications – even those that have effectively controlled their medical condition for years. No one can understand the logic behind the high and fluctuating prices. We hope the administration can bring some transparency – and relief – to patients.”
During a Rose Garden ceremony to introduce the initiative, President Trump said he is targeting foreign countries that require manufacturers to sell their products well below list prices as a condition of selling in their country, forcing Americans to absorb the research and development costs via higher prices for drugs.
“It’s time to end the global freeloading once and for all,” President Trump said. “I have directed U.S. Trade Representative Bob Lighthizer to make fixing this injustice a top priority with every trading partner.”
One proposal President Trump campaigned on – giving the federal government the power to directly negotiate for drug prices – was not included in the plan.
“I am very disappointed that he has apparently dropped his support for allowing Medicare to negotiate the price of prescription drugs,” Sen. Maggie Hassan (D-N.H.) said in a statement.
Also absent from the plan: a direct negotiation tactic for Part B drugs supported by Mr. Azar during his confirmation hearings.
The Trump administration believes it is a “right that, when you are sitting there with your doctor, you ought to be able to know what your out-of-pocket [cost] is for drug you are going to be prescribed under your precise drug plan. And you ought to have information on what competing drugs are that your doctor is not prescribing and what you would pay out of pocket for that.”
Price transparency is a key theme to the broad package of proposals called American Patients First that the White House released May 11. The plan includes changes that can be made immediately as well as some upon which the administration will seek public comment, according to the plan.
Another tactic the administration is considering for quick action is requiring a drug’s list prices to be included in all direct-to-consumer advertising.
The plan also calls for the banning of gag rules that prevent pharmacists from alerting patients when it would be cheaper to buy a prescribed drug without going through their insurance coverage, as well as moving certain drugs from Medicare Part B to Medicare Part D to improve the government’s ability to negotiations for lower prices.
The overall strategy is laid out across four areas:
- Increasing competition though policy measures that prevent manufacturers from gaming the patent system and promoting innovation and competition among biologics.
- Improving negotiation abilities, including doing more with value-based purchasing; allowing for more substitution, especially in the case of single-source generics; and further examination of the competitive acquisition program for Part B.
- Providing incentives to manufacturers to lower their list prices.
- Lowering out-of-pocket costs.
Currently, there is no incentive to lower drug prices, Mr. Azar noted. He called out pharmacy benefit managers (PBMs) for financially benefiting from both manufacturers and the insurers they represent and said HHS is looking into banning financial compensation to PBMs from the manufacturers. He also said the agency will be releasing a request for information on the feasibility of doing away with rebates as a means of driving manufacturers to lower their prices.
PhRMA, the lobbying group representing pharmaceutical manufacturers, said in a statement that some of the changes related to Part D “could undermine the existing structure of the program that has successfully held down costs and provided seniors with access to comprehensive prescription drug coverage. We also must avoid changes to Medicare Part B that could raise costs for seniors and limit their access to lifesaving treatments.”
The Pharmaceutical Care Management Association, the lobbying group for pharmacy benefit managers, also spoke out against the idea of eliminating rebates, noting in a statement that getting rid of them “and other price concessions would leave patients and payers, including Medicaid and Medicare, at the mercy of drug manufacturer pricing strategies. PBMs have long encouraged manufacturers to offer payers alternative ways to reduce net costs. Simply put, the easiest way to lower costs would be for drug companies to lower their prices.”
The American Medical Association voiced support for the plan.
“The AMA is pleased the Trump administration is moving forward with its effort to address seemingly arbitrary pricing for prescription drugs,” President David Barbe, MD, said in a statement “Physicians see the impact of skyrocketing prices every day as patients are often unable to afford the most medically appropriate medications – even those that have effectively controlled their medical condition for years. No one can understand the logic behind the high and fluctuating prices. We hope the administration can bring some transparency – and relief – to patients.”
During a Rose Garden ceremony to introduce the initiative, President Trump said he is targeting foreign countries that require manufacturers to sell their products well below list prices as a condition of selling in their country, forcing Americans to absorb the research and development costs via higher prices for drugs.
“It’s time to end the global freeloading once and for all,” President Trump said. “I have directed U.S. Trade Representative Bob Lighthizer to make fixing this injustice a top priority with every trading partner.”
One proposal President Trump campaigned on – giving the federal government the power to directly negotiate for drug prices – was not included in the plan.
“I am very disappointed that he has apparently dropped his support for allowing Medicare to negotiate the price of prescription drugs,” Sen. Maggie Hassan (D-N.H.) said in a statement.
Also absent from the plan: a direct negotiation tactic for Part B drugs supported by Mr. Azar during his confirmation hearings.
The Trump administration believes it is a “right that, when you are sitting there with your doctor, you ought to be able to know what your out-of-pocket [cost] is for drug you are going to be prescribed under your precise drug plan. And you ought to have information on what competing drugs are that your doctor is not prescribing and what you would pay out of pocket for that.”
Price transparency is a key theme to the broad package of proposals called American Patients First that the White House released May 11. The plan includes changes that can be made immediately as well as some upon which the administration will seek public comment, according to the plan.
Another tactic the administration is considering for quick action is requiring a drug’s list prices to be included in all direct-to-consumer advertising.
The plan also calls for the banning of gag rules that prevent pharmacists from alerting patients when it would be cheaper to buy a prescribed drug without going through their insurance coverage, as well as moving certain drugs from Medicare Part B to Medicare Part D to improve the government’s ability to negotiations for lower prices.
The overall strategy is laid out across four areas:
- Increasing competition though policy measures that prevent manufacturers from gaming the patent system and promoting innovation and competition among biologics.
- Improving negotiation abilities, including doing more with value-based purchasing; allowing for more substitution, especially in the case of single-source generics; and further examination of the competitive acquisition program for Part B.
- Providing incentives to manufacturers to lower their list prices.
- Lowering out-of-pocket costs.
Currently, there is no incentive to lower drug prices, Mr. Azar noted. He called out pharmacy benefit managers (PBMs) for financially benefiting from both manufacturers and the insurers they represent and said HHS is looking into banning financial compensation to PBMs from the manufacturers. He also said the agency will be releasing a request for information on the feasibility of doing away with rebates as a means of driving manufacturers to lower their prices.
PhRMA, the lobbying group representing pharmaceutical manufacturers, said in a statement that some of the changes related to Part D “could undermine the existing structure of the program that has successfully held down costs and provided seniors with access to comprehensive prescription drug coverage. We also must avoid changes to Medicare Part B that could raise costs for seniors and limit their access to lifesaving treatments.”
The Pharmaceutical Care Management Association, the lobbying group for pharmacy benefit managers, also spoke out against the idea of eliminating rebates, noting in a statement that getting rid of them “and other price concessions would leave patients and payers, including Medicaid and Medicare, at the mercy of drug manufacturer pricing strategies. PBMs have long encouraged manufacturers to offer payers alternative ways to reduce net costs. Simply put, the easiest way to lower costs would be for drug companies to lower their prices.”
The American Medical Association voiced support for the plan.
“The AMA is pleased the Trump administration is moving forward with its effort to address seemingly arbitrary pricing for prescription drugs,” President David Barbe, MD, said in a statement “Physicians see the impact of skyrocketing prices every day as patients are often unable to afford the most medically appropriate medications – even those that have effectively controlled their medical condition for years. No one can understand the logic behind the high and fluctuating prices. We hope the administration can bring some transparency – and relief – to patients.”
During a Rose Garden ceremony to introduce the initiative, President Trump said he is targeting foreign countries that require manufacturers to sell their products well below list prices as a condition of selling in their country, forcing Americans to absorb the research and development costs via higher prices for drugs.
“It’s time to end the global freeloading once and for all,” President Trump said. “I have directed U.S. Trade Representative Bob Lighthizer to make fixing this injustice a top priority with every trading partner.”
One proposal President Trump campaigned on – giving the federal government the power to directly negotiate for drug prices – was not included in the plan.
“I am very disappointed that he has apparently dropped his support for allowing Medicare to negotiate the price of prescription drugs,” Sen. Maggie Hassan (D-N.H.) said in a statement.
Also absent from the plan: a direct negotiation tactic for Part B drugs supported by Mr. Azar during his confirmation hearings.