ACP calls for changes to combat rising prescription drug costs

November 14, 2019

ACP made recommendations to address prices in two new policy papers

The American College of Physicians (ACP) released recommendations to combat the rising price of prescription drugs, according to a November 12 news release.

Published in two policypapers in the Annals of Internal Medicine, ACPs recommendations  focus on improving transparency in the industry and government and examine the role of pharmacy benefit managers (PBMs).

They expand on ACP’s previous policy paper from 2016 by focusing on the need for increased transparency in drug pricing, lowering patients’ out-of-pocket cost, enhancing governmental purchasing power, and examining the roles PBMs and public health plans play in the drug industry.

“The U.S. pays more for prescription drugs than any other developed country-putting a great strain on our patients,” says Robert McLean, MD, president of ACP, in the release. “As physicians, we have a responsibility to address issues that create obstacles to care for our patients, including skyrocketing prescription drug costs.”

ACP recommends:

·      Improved transparency, standards, and regulations for PBMs including a ban on gag clauses preventing pharmacies from sharing price information with patients

·      Increased PBM oversight and regulation as mergers and consolidations could reduce competition raising costs to patients

·      Reporting of price paid for drugs by health plans, PBMs, and pharmaceutical manufacturers and aggregating the amounts of rebates and non-proprietary information to HHS and making it publicly available

The papers also examine the roles of public health plans like Medicare and Medicaid which can raise costs in the healthcare system and recommends:

·      Modifying the Medicare Part D low income subsidy program cost-sharing and copayment structures to encourage using lower-cost generic or biosimilar drugs

·      Caps for annual out-of-pocket spending for Medicare Part D beneficiaries who reach the catastrophic stage of coverage

·      Adopting Medicare Part D negotiation models that would drive down prescription drug prices for beneficiaries

·      Minimizing the financial impact on the federal government misclassifying prescription drugs in the Medicaid Drug Rebate Program

·      Further study of payment models in federal healthcare programs

“Internists have seen first-hand the how the increasing costs of prescription drugs have impacted patients,” McLean says. “Not all patients can afford the expensive out-of-pocket costs for vital drugs, and the high price tag can cause patients to not adhere to their medications, take incorrect doses to make their supply last longer, or forgo the medication they need altogether. It’s more important than ever to continue advocating for policies that make prescription drugs more affordable and accessible to patients, and ensure they are not boxed out of the care they need.”

titled Policy Recommendations for Public Health Plans to Stem the Escalating Costs of Prescription Drugs: A Position Paper From the American College of Physicians and Policy Recommendations for Pharmacy Benefit Managers to Stem the Escalating Costs of Prescription Drugs: A Position Paper From the American College of Physicians