Feds, Big Pharma issue competing price transparency plans

The war of words between Big Pharma and the Trump administration over soaring drug prices escalated last week with a pair of dueling news releases.

Hours before the CMS issued a proposed regulation on price transparency, the trade group Pharmaceutical Research and Manufacturers of America announced modifications to its voluntary guidelines on direct-to-consumer advertising. Mainly, PhRMA members will nudge consumers toward online resources to find pricing information.

The CMS is advancing its own course of action. A proposed rule released Oct. 15 would force drug manufacturers to post list prices directly in TV ads. The move comes barely a month after President Donald Trump signed legislation banning so-called gag clauses, which prohibited pharmacies from telling patients if they would save money by paying out-of-pocket for drugs in lieu of their plans' co-payments.

While eliminating the gag clause and forcing pharmaceutical manufacturers to disclose list prices in TV spots will not bring unsustainable drug pricing under control by themselves, they represent the first tangible action at the federal level, said Scott Knoer, chief pharmacy officer at the Cleveland Clinic. “I think there is value to having that information in the public eye. People have no idea what these therapies cost,” said Knoer, citing Bausch Health's toenail fungus drug Jublia, which can cost $10,000 to $20,000 for a full course of therapy. “Transparency is critical for driving potential solutions.”

In a snapshot, here's how the two sides line up on direct-to-consumer advertising.

Some of PhRMA's previously approved 
guiding principles:

• All “information
 should be accurate, 
truthful and not misleading, 
should make claims only 
when supported by 
appropriate 
evidence.”
• Advertising 
should include 
information about other options, including 
diet and lifestyle changes.
• Companies should
include information 
“where practical and appropriate” that directs patients to resources “that may help them with the 
cost of their medicine.”
• The latest addition: All TV ads that mention
a medicine by name should 
direct patients to information
about cost, “such as a 
company-developed website, including the list price and average, estimated, 
or typical patient out-of-pocket costs, 
or other context about 
the potential cost
of the medicine.”

The CMS' proposed rule

• Would require TV ads to show list prices for short-term and 30-day prescriptions.
• Information “would take the form of a legible textual statement at the end of the ad.”
• Seeks comment on whether the requirement should also apply to radio, web, print and social media advertising.
• HHS would maintain a public list of drugs that violate the rule.
• Drugs with list prices under $35 per month would be exempt.