On Wednesday, Health and Human Services Secretary Alex Azar announced a final rule from the Centers for Medicare & Medicaid Services (CMS) that will require direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or Medicaid to include the list price – the Wholesale Acquisition Cost – if that price is equal to or greater than $35 for a month’s supply or the usual course of therapy.
Introduced in May 2018, “American Patients First - PDF blueprint to bring down prescription drug prices,” laid out four strategies for solving the problems patients face:
· boosting competition
· enhancing negotiation
· creating incentives for lower list prices
· bringing down out-of-pocket costs
The agency said this final rule implements the vision laid out in the blueprint.
“American patients deserve to know the prices of the healthcare they receive,” said Azar in Wednesday morning’s press announcement. “Patients who are struggling with high drug costs are in that position because of the high list prices that drug companies set.”
Up until now, drug companies were required to disclose the major side effects a drug can have - but not the effect that buying the drug could have on your wallet. Patients deserve more transparency, and this Administration is committed to delivering it.
HHS added in the announcement that list prices matter to patients and the 47 percent of Americans who have high-deductible health insurance plans, the price they see in ads essentially is the price they pay, until they meet their deductible. All seniors on Medicare Part D have coinsurance for certain types of drugs, which means their out-of-pocket expenses are calculated as a share of list price. List prices are also what patients pay if a drug is not on their insurance formulary.
