President Trump Vows to Lower Drug Prices
President Trump vowed to lower drug prices for Americans and outlined a strategy to create private-sector incentives. He also stated that Medicare would not be allowed to use its influence to negotiate bargain prices. With these promises, will Trump be able to fulfill all he has promised and more? How does he plan to create lower prices, and how can this influence your healthcare?
There’s a lot in the President’s blueprint, but in summary, it encourages innovation, while also promoting better price competition and addresses those who might be taking advantage of the program. Outlined is his blueprint provided by whitehouse.gov, The Department of Health and Human Services (HHS) will:
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- Take steps to end the gaming of regulatory and patent processes by drug makers to unfairly protect monopolies.
- Advance biosimilars and generics to boost price competition.
- Evaluate the inclusion of prices in drugmakers’ ads to enhance price competition.
- Streamline and accelerate the approval process for over-the-counter drugs.
- Speed access to lower cost of new drugs by clarifying policies for sharing information between insurers and drug makers.
- Avoid excessive pricing by relying more on value-based pricing by expanding outcome-based payments in Medicare and Medicaid.
- Work to give Part D plan sponsors more negotiation power with drug makers.
- Examine which Medicare Part B drugs could be negotiated for a lower price by Part D plans, and improving the design of the Part B Competitive Acquisition Program.
- Update Medicare’s drug-pricing dashboard to increase transparency.
- Prohibit Part D contracts that include “gag rules” that prevent pharmacists from informing patients when they could pay less out-of-pocket by not using insurance.
- Require that Part D plan members be provided with an annual statement of plan payments, out-of-pocket spending, and drug price increases.
- Work across the Administration to address intellectual property theft and foreign freeloading.
The President’s blueprint also seeks feedback about other potential actions, including:
- Reserving certain Part D incentives only for drug makers that stop raising prices.
- Ending Obamacare’s Medicaid rebate cap, which encourages higher drug prices.
- Including drug maker copay discount cards in Medicaid best price calculations.
- Making changes to the Medicaid Drug Rebate Program rules to remove barriers to innovation and competition.
- Reducing incentives to deliver Medicare Part B drugs in the most expensive setting.
- Requiring Pharmacy Benefit Managers to act in the best interests of patients.
- Paying for value in Medicare to spur development of drugs that cure illnesses rather than simply manage symptoms.
- Requiring beneficiaries to be told what their out-of-pocket costs will be prior to receiving a Part B drug or a Part D drug prescription, and whether lower-cost alternatives exist.
- Requiring “safety net” hospitals paid under Medicare Part B to use their 340B drug discounts to provide care to more low-income and vulnerable patients.
- Having the U.S. Trade Representative prioritize addressing unfair intellectual property and market access policies in our trade agreements so that partners contribute their fair share to innovation.
- Having the Administration publish a comparison of drug prices in the United States with those in other OECD countries, to examine freeloading.
The President also included a budget proposal on how to allocate money to lower drug prices. Inside the proposed reforms to Medicare Part D program include:
- Allowing greater flexibility in benefit design to encourage better price negotiation.
- Offering free generics to low-income seniors.
- Requiring plans to share a minimum portion of drug rebates with patients.
- Discouraging plans from accelerating beneficiaries into the catastrophic phase of the benefit with costly brand-name drugs.
- Protecting seniors from catastrophic costs through a new out-of-pocket maximum, while ensuring plans are incentivized to limit excessive costs.
- Reforming Medicare Part B, proposed by the President, to limit payment for price increases that are above the inflation rate and cut incentives for doctors to write high-priced prescriptions.
- Reforms to ensure hospitals paid under Medicare Part B provide more than one percent of their patient costs in charity care could retain a discount under the 340B program.
- Actions to maximize competition and innovation, including curbing abuse of FDA safety rules and the 180-day “first-to-file” exclusivity clock.
Stay tuned for an informational video over the blueprint by one of our Product Specialist.
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