- Insurers and medical groups are generally in support of the Trump administration's proposal to require drugmakers list prices in television advertisements for their products, but question how such a rule would be enforced and whether it would have the intended effect of lowering drug costs in the U.S.
- Cigna and Kaiser Permanente, as well as AARP, the American Medical Association and other medical groups, submitted comments to the Centers for Medicare and Medicaid Services that backed the White House's push on mandating price disclosure in direct-to-consumer TV marketing. Some, including Humana, supported further steps to curtail DTC advertising more broadly.
- Predictably, the positive comments stand in contrast to the position of the drug industry, which has strongly opposed the proposal from the White House. BIO, the major trade group representing biotech, claimed the plan would mislead patients and argued it would not withstand legal scrutiny.
In October, the Trump administration rolled out a proposal via CMS which seeks to force drugmakers to display drug list prices in TV ads, an advertising medium which the industry spends billions of dollars on each year.
Beyond transparency, the plan is essentially aimed at shaming drugmakers to curtail steady price increases on their products.
Since the rule was proposed, the administration has rolled out further policy ideas, such as an initial framework for linking Medicare reimbursement on certain drugs to prices paid abroad, that put further impetus behind its efforts around drug pricing.
Requiring list prices in TV ads, however, still represents a change that consumers would be likely to notice immediately, if the proposed rule ever comes into force.
That's a legitimate question, as the legal basis by which the administration hopes to enact its plan is questioned by the industry as well as outside legal experts. HHS, however, is convinced of the proposal's legal grounds.
Practical details, such as whether a drug's wholesale acquisition cost is the right figure to cite, remain as well.
Comments submitted to the administration in response to the proposed rule reflect some of this uncertainty, as well as the divide between the drug industry and other healthcare groups on the idea's merits. A total of 146 comments were submitted, although only about 100 are currently available to view on a federal repository.
Despite viewing the proposed rule favorably, both the AARP, the AMA and Cigna noted concerns around how such a rule would be enforced. Currently, the administration proposes to publish a list of drugs which are supported by ads incompliant with the rule.
Some, including AARP, argue the plan should not be limited to TV ads in order to avoid drugmakers diverting their advertising spending to other mediums, like print or digital.
BIO, expectedly, came out strongly in opposition to the rule.
"It is likely to confuse consumers, causing them not to seek necessary medical care and not to have more informed discussions with their health care providers," the group wrote in its comment on the proposed rule.
In its comment, BIO also lent its support to a framework proposed by PhRMA to direct consumers in TV ads to other places where they can find out more about pricing.
"We believe that PhRMA's revised DTC principles can help provide significantly more patient appropriate context for understanding and evaluating drug prices than CMS' proposed Rule. In fact, BIO has encouraged our own members to consider voluntarily certifying to PhRMA’s principles," noted the group.
A number of groups, including Humana, doubted whether the rule would even help to reduce drug prices.
Patients for Affordable Drugs, an advocacy group run by David Mitchell, put it more bluntly: "The disclosure of drug list prices in direct-to-consumer television ads is an appropriate step to increase price transparency for patients. We have not, however, seen any evidence that it will lower drug prices," the group wrote in its comment.
The period for comment on the proposed rule is now closed, but the rule would need to be finalized by CMS before more substantive outside action, such as any forthcoming legal challenges.