The nation's top health officer proposed Monday that pharmaceutical companies are obliged to include the list price of drugs in television advertising with consumers – the boldest element of a series of Trump administration's efforts to curb drug spending.
According to a major Alex Azar Health and Human Services change and drafted as a new federal rule, drug manufacturers should list the 30-day delivery price of each drug covered by Medicare and Medicaid and at the very least cost $ 35 per month .
"Sometimes it is necessary for the government to take the first step, disrupt a broken system and set new rules," said Azar, a typical supporter of market-oriented approaches, in a speech that took place Monday before the National Academy of Medicine.
The shift, which is now taking place for months of debate before the proposed amendment of the rule becomes final, intensifies a tug of war between the pharmaceutical industry and a secretary of the HHS that has emerged from his ranks and has sought to change every perception of attunement. drive away. with his former fellow medicine man.
The proposed regulation is the latest attempt by the Trump administration and some members of Congress to force pharmaceutical companies to announce the list prices of medicines in TV ads – a strategy that would test the point of view of proponents that consumers would be more price-sensitive. be, in turn, slowing the rise in pharmaceutical costs that have been one of the major causes of the unusually high healthcare expenditures in the United States in recent years.
Hours before the speech of the HHS secretary for the National Academy of Medicine, the major pharmaceutical lobby group announced a new voluntary action that would send consumers to corporate websites with pricing information.
The announcement by PhRMA, the pharmaceutical research and the manufacturers of America, was seen by experts as an attempt to ward off more aggressive federal regulation. Azar issued a statement before his speech and said that "the pharmaceutical industry continues to resist offering genuine transparency around their prices" and that the government should go beyond what he called a "small step in the right direction" by the industry
The industry is also facing pressure from Congress. A twofold proposal that should have included the price of medicines in TV ads passed through the Senate, but was removed from a House of Appropriations account last month.
The voluntary action of the industry, which starts on April 15, would give patients a variety of price information, including the list price of a drug, the expected out-of-pocket costs of the drug and the available tools for patients . .
Steve Ubl, president of PhRMA, stated that revealing just the list price of a drug in a television ad "is very confusing, misleading, lacking the right context and is not what patients want or need." He predicted that the price, which would not reflect what most people would pay, could prevent patients from seeking medical attention because the patient's own costs vary depending on their insurance plans.
Rachel Sachs, associate professor at Washington University at St. Louis School of Law, said it was unclear how or why disclosure of prices in advertising would lower drug prices.
"With that aside, what PhRMA is doing here is clearly an attempt to prevent some of the public's concern," Sachs said. "Realistically, how many patients go to the website and if they do, the extra pieces of information can be even more confusing."
Many questions remain about the website: the "list price" of the drug may vary depending on the dosage and formulation of a drug, and companies should choose how to report the price in that case. The out-of-pocket costs of medicines may vary depending on a patient's plan, sometimes ranging from $ 0 to the full price of the drug, so it is unclear how meaningful an estimated price range or average cost to patients is.
Ubl said at a press conference that there would be possible First Amendment and legal objections if the administration were to submit a rule requiring price information to be contained in an advertisement, indicating that proposing such a requirement would require a lengthy legal battle between the US government and one of the most powerful lobby in the country.
Sachs said that if the case comes to a legal battle, it could transfer the energy from the greater effort of the administration to reduce the costs of medicines, including a blueprint with dozens of policy ideas.
"It is unfortunate if the agency chooses to spend its legal capital on regulations that clearly do not affect the prices of medicines," Sachs said. "There are so many actions that the administration could take … that would make a big difference for patients."