As policymakers seek to address widespread concern about high drug prices, the conversation often includes a call for greater transparency for patients, purchasers and payers. We agree that educating and empowering consumers – whether it be individuals, businesses or government – with information they can use to make choices is key to a functioning marketplace that prioritizes access and improved health outcomes.
It is critical, however, that any transparency proposal provide the opportunity for information and oversight without undermining the tools that drive prices down in the current system. The focus of a transparency effort should be on policies that will meaningfully help drive toward better care and lower drug costs at the pharmacy counter.
One clear example is tools that provide relevant, timely information for doctors and patients on drug costs at the point of prescribing. Recent studies have shown that 57% of consumers don’t know what the price of their prescription drugs will be when they reach the pharmacy counter, and nearly 50% have abandoned a prescription because of cost. Making benefit information available to providers as they, together with patients, decide on a course of treatment increases their ability to prescribe a drug that their patient can actually afford and will therefore be much more likely to pick up at the pharmacy.
Pharmacy Benefit Managers (PBMs) already provide real-time benefits tools to ensure doctors have pricing information at the point-of-prescribing. These programs are producing encouraging results: through one PBM’s tool, physicians prescribed a different, lower-cost drug about 20% of the time when an alternative was available, and consumers saved on average $80 per prescription fill.
CAPD also supports increased transparency for consumers at the pharmacy counter. PBMs have developed mobile apps and online tools for patients to access pricing information so they know exactly what their drug will cost and can see lower-cost alternatives for themselves.
In an effort to better understand pricing, some have called for transparency regarding rebates and discounts in the drug supply chain. We agree that this information should be available to policymakers to ensure the system is working correctly for patients. Toward that end, CAPD supports the disclosure of rebates and discounts negotiated by PBMs from drug manufacturers and passed through to their clients to the two influential advisory bodies to Congress on Medicare and Medicaid, MedPAC and MACPAC. Sharing this information with independent experts will help them recommend needed improvements to these programs to keep drug prices low for beneficiaries and taxpayers, without compromising the savings achieved from PBM negotiations with drug manufacturers.
Transparency is a critical component to any policy solutions around drug pricing. Let’s make sure that the policies drive information that consumers and policymakers can actually use to lower drug prices and improve the system.