Drug Pricing and Cost Transparency
by Denis Knight, DO
I recently returned from the 2017 AMA House of Delegates Interim Meeting in Honolulu, where I was pleased to see delegates reaffirm their stands on an issue I am passionate about – drug price and cost transparency – and approve additional steps to bring it about.
All practicing physicians have confronted the serious problem of rising medication costs and seen how they can limit access to affordable health care in America. In the past, delegates acknowledged the problem by approving policies on the matter, and in Hawaii they stood by those stances.
One earlier policy, H-110.987, supports legislation requiring pharmaceutical companies and pharmacy benefit managers to provide public notice before increasing the price of any drug by
10 percent or more each year or per course of treatment and to justify the price increase. It also advocates legislation authorizing the U.S. attorney general or the Federal Trade Commission – or both – to take legal action to address price gouging.
Another previous policy, H-125.986, encourages the Federal Trade Commission and the Food and Drug Administration to continue monitoring the relationships between drug manufacturers and pharmacy benefit managers with regard to how manufacturers influence the managers’ drug formularies and drug product switching programs.
The newest policy step addresses the AMA’s opposition to provisions in pharmacies’ contracts that prohibit pharmacists from disclosing that a patient’s co-pay is higher than the drug’s cash price. The new policy also advocates for a prohibition on price gouging for medications when there are no justifiable factors or data to support the price increase. The delegates’ directives include having the AMA work with the National Association of Insurance Commissioners to address the development and management of pharmacy benefits, develop model state legislation on the development and management of pharmacy benefits, continue the implementation of the AMA TruthinRx grassroots campaign, and report back to the House of Delegates at the 2018 Interim Meeting about progress on all those matters.
I would encourage all Medical Society of Sedgwick County members to go to the TruthinRx website (truthinrx.org), as it has important information that you can share with your patients. We can together gather data that holds the drug manufacturers, the wholesale and retail pharmacies and the pharmacy benefit managers accountable. It explains in a simple but effective manner how the relationship with all the above is working to raise their margins and make even older and generic medications unaffordable and unobtainable.
There are many other sources for following these businesses. Whatever news sources you follow, it’s important to stay apprised, as their actions affect the practice and business of medicine as well as the lives of our patients.
In Honolulu, I was proud to see AMA delegates and alternate delegates – MSSC and KMS members like yourself – actively engaged in policy-making that clearly signaled their desire to hold corporate health care and its business practices accountable.