Drug prices still rising; relief for patients unlikely

    Consumers hoping a couple of recent policy proposals might lower prices for their prescription drugs may be out of luck, at least for now.
    Earlier this year the Trump administration had proposed a rule that would have required prescription drug manufacturers to disclose list prices for drugs advertised on TV. Drug makers would have had to tell the public the list price of a 30-day supply of any drugs covered under the Medicare and Medicaid programs that cost at least $35 a month.
    Some experts argued the rule would not have been very effective because consumers often don’t pay the list price anyway. Discounts and rebates negotiated by pharmacy benefit managers reduce the price, although some insurers may require people with high deductible plans to pay the list price until they meet their deductible.
    Almost half of all Americans with a health insurance plan that offers drug coverage must pay a minimum of $1,300 out of pocket for an individual and $2,600 for a family before they reach their deductible and benefits kick in. The administration had argued that showing what the drugs would cost people before their drug benefits took effect was important.
    This modest move to transparency in a very opaque industry was a start.
    But right after the July 4 weekend, a U.S. District Court judge in Washington, D.C., blocked the Trump administration from implementing the rule. He sided with a coalition of drug companies including Eli Lilly, Merck, and Amgen and the Association of National Advertisers, which had joined the suit.
    Drug companies, it seems, weren’t keen on price transparency.
    The judge ruled the government did not have the authority to compel drug companies to disclose their prices.
    A few days after the judge’s ruling came another blow to lower pharmaceutical prices. This time the Trump administration killed its own proposal released earlier this year. That proposal had aimed at the pharmacy benefit managers, commonly known as PBMs, the controversial middlemen in the drug pricing chain, hired by insurers to help manage the drug benefits they sell.
    The Trump administration’s proposed rule would have made it illegal for drug makers to offer rebates to the PBMs and insurers unless the middlemen passed any savings on to patients in the form of lower co-pays and coinsurance. It would have applied only to Medicare drug plans, not coverage from private insurers.

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