January 1 marks the first day US hospitals must comply with the Inpatient Prospective Payment System rule to post the price for each individually offered service on their websites. Advocates for price transparency are pretty happy, but providers aren’t—92% of them are concerned about the new policy. After all, list prices aren’t out-of-pocket prices. Providers are also concerned about other initiatives in 2019, including the International Pricing Index proposed by the White House to bring American drug costs in line with other developed nations. Another policy to watch is the proposal to include prescription drug costs in DTC TV ads. Drugmakers have a lot to spend on ads considering they spent $3.7B on them in 2018, so maybe that change won’t be too hard to make monetarily-speaking. Speaking of drug pricing, here’s 2018’s most expensive retail pharmacy drugs.
While “America First” is a rallying cry for supporters of President Donald Trump, one thing they don’t want to be first in is prescription drug pricing. Following up on last week’s proposal to mandate the displaying drug pricing in TV ads, the US President took aim at the pharmaceutical industry for charging more in the States as compared to other industrialized nations. He criticized those countries for freeloading on the US’s inflated prices saying, the “American middle class is effectively funding virtually all drug research and development for the entire planet.” To address this, the Department of Health and Human Services released a proposal that would tie Medicare Part B payments for medicines to the levels that other nations pay. HHS Secretary Alex Azar did note this could cause companies to stop selling some drugs in other countries… probably not a big concern for the America First crowd.
While any DTC drug commercial will likely include shots of people happily hiking and a list of side effects longer than the symptoms of the disease it’s curing, one thing you won’t see advertised is the price of the prescription. New federal policy could change that for drugs covered under Medicare and Medicaid, forcing companies to disclose list prices in TV advertisements. While most patients don’t typically pay the full price for their prescriptions, Health and Human Services Secretary Alex Azar says, “They deserve to know if the drug company has pushed their prices to abusive levels.” PhRMA says their members would be willing to include a link to a website that has pricing information in advertisements, to which Azar pretty much replied, that’s not what I meant.
Source: SERMO and Buzzfeed
Sometimes an envelope and poorly thought out patient privacy procedures are all you need for a data breach, as Aetna discovered last summer. The insurance company was, no joke, sending out letters in response to a previous privacy violation, notifying patients who took the HIV preventative PrEP about changes to ordering the medication. So they put this information in an envelope with a nice, oversized window where you can see the patient’s name and a reference to HIV prescriptions. That’s a patient privacy nightmare for any condition, and it’s made worse due to the stigma still surrounding the virus. Aetna agreed to pay $17M to the patients last Wednesday, which will presumably come in the form of checks with the memo “We’re sorry about telling everyone about your HIV status.”