Government

The drug costs what?

The Department of HHS has released a regulation requiring direct to consumer ads for prescription drugs to contain the retail price (if the price is more than $35 a month).

Big deal‼️

When was the last time you went to the pharmacy and simply bought a prescription drug like buying a new toothbrush? The answer is never … because you need a prescription from your doctor. So what is the point of telling consumers the retail price of a drug? Virtually no one pays the retail price. Even patients with a high deductible plan pay the plans negotiated price, not the retail price, until the deductible is met.

Is telling patients a misleading price going to prevent them from filling a prescription or will they simply tell their doctor, no thanks, that drug is too expensive. I d o n ‘ t t h i n k s o. Confusion abounds.

“better able to make informed decisions and demand value from pharmaceutical companies.” what decision? To forego their medications? Informed decisions? Informed about what, a price that has no relevance?

This is nothing but more the patient as consumer bunk.

If we really want to change things, ban direct to consumer advertising. Why should we be encouraging patients to ask doctors to prescribe a certain drug (or any drug)?

HHS Finalizes Rule Requiring Manufacturers Disclose Drug Prices in TV Ads to Increase Drug Pricing Transparency 

Less than a year after the release of President Trump’s American Patients First – PDF blueprint, HHS finalizes first rule implementing the blueprint, aimed at increasing transparency for patients and bringing down overall drug costs both for patients and for the Medicare and Medicaid programs. 

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.

“Requiring the inclusion of drugs’ list prices in TV ads is the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the healthcare they receive,” said HHS Secretary Alex Azar. “Patients who are struggling with high drug costs are in that position because of the high list prices that drug companies set. Making those prices more transparent is a significant step in President Trump’s efforts to reform our prescription drug markets and put patients in charge of their own healthcare.”

“Patients have the right to know the prices of healthcare services, and CMS is serious about empowering patients with this information across-the-board,” said CMS Administrator Seema Verma. “Today’s final rule is an important step toward achieving President Trump’s vision for lowering prescription drug prices by bringing much-needed pricing transparency to the convoluted market for prescription drugs. Equipped with information on prescription drug prices, patients will be better able to make informed decisions and demand value from pharmaceutical companies.”

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3 replies »

  1. I agree that advertising drugs is unnecessary. How much money does the pharmaceutical company spend to do this? And, then assert that the cost of the new drug is necessary due to R&D. Eliminate the ads!

    Revealing the retail cost of the drug to consumers at least gives a starting point of understanding the costs associated with the ‘negotiated’ price of a drug. In my line of work I explain to consumers that the price on their ‘tiered’ drug plan represents a percentage of the actual cost of the drug. Yes it is negotiated but it also falls within a certain block of costs. Generic retail price is lower than a newly released ‘branded’ drug and therefore costs less but that doesn’t mean that when I pay a zero co-pay that generic cost is zero.

    Explaining the “Coverage Gap” or “Donut Hole” to consumers I find that most if not all of my clients understand the ‘negotiated’ cost and how they reach the ‘Donut Hole” Revealing the retail cost of the drug at least gives them an option of talking to their doctor about how it might help them. Right now some clients go to pick up a Rx that has been electronically sent to the pharmacy, filled by the pharmacist and held ready to be picked up, only to be told, no I will speak with my doctor about a lesser cost drug.

    Insurers of Prescription Drug Plans (PDP) negotiate prices for drugs and their formulary changes yearly as well as the tiers they put the drug into. Believe me my clients know that they must review their plan changes yearly even if their medications have not change.

    Again, I feel this is a good basis for consumers to see. I think you are not giving the average citizen enough credit!

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  2. The TV ads are insane and should be prohibited. They do nothing but encourage us to just take a pill for everything. Yes, I know there are real health reasons that require medication, but the doctor already knows what to prescribe. And, then there are all the precautions noted at the end of the commercial. It all boils down to pushing a pill to make $$$$ – very wrong all the way around.

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  3. I agree that direct drug advertising should be banned or prove that the cost is not added to the price of the drug. My doctor should be telling me what drugs I need and then it is up to my drug coverage plan on what I am allow to get.

    Stating the cost of the drug in a TV ad is like the a hotel room rate on the back of the door. Nobody ever pays that rate. I have paid as little as 25% of the posted room rate. But I guess they post the highest room rate they think they can get away with like a room on Times Square on New Years Eve. So stating the drug cost would be meaningless. Or they can say that they are now on sale because you are not paying the full rate. Or a plan can say that they will save you 75% on these drug if they can cut a deal with the manufacturer.

    I would like to know the wholesale cost but I know that there are so many variables that it would probably be meaningless too. The drug cost between hospitals, brick & mortar pharmacies, and mail order pharmacies are great but how much is due to the handling costs vs the price of a pill? For example, a hospital has to track each pill from its pharmacies to a patient on some floor whereas a mail order sends 90 pills directly to you, not one pill.

    The reason I would like this information is to better help me pick my health plans. I picked my current plan because I know that it covers one drug that use that other plans do not cover. Comparing healthcare plans is like comparing two shopping carts. They are both full, but without digging through them, you don’t know if you are comparing apples to apples and you just can’t get that information. And sometimes, the cart is just left out in the middle of the parking lot until you need it and it’s the one with the bad wheel.

    I do not see how stating the price is going to help other than scare people away. Or it might make these advertisement for a drug that cost $250K for 5 extra months of life, stop being advertised.

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