The Trump administration believes it is a “right that, when you are sitting there with your doctor, you ought to be able to know what your out-of-pocket [cost] is for drug you are going to be prescribed under your precise drug plan. And you ought to have information on what competing drugs are that your doctor is not prescribing and what you would pay out of pocket for that.”
The information is critical, regardless of a patient’s insurer, Alex M. Azar II, secretary of Health & Human Services, said at a press briefing. “Let me give you an example. You are in with the doctor. This doctor has an infusion clinic as part of their office. They write you a [prescription for a] drug that might be an infused drug. You might have a $300 copay for that. Well, wouldn’t you like to know that if the doctor instead wrote you a [prescription for a] self-injectable drug, you would have a $20 copay and you could at least have an informed discussion? So we think that kind of informed consumer on out of pocket will also help drive real savings in the system.”Price transparency is a key theme to the broad package of proposals called American Patients First that the White House released May 11. The plan includes changes that can be made immediately as well as some upon which the administration will seek public comment, according to the plan.
Another tactic the administration is considering for quick action is requiring a drug’s list prices to be included in all direct-to-consumer advertising.
The plan also calls for the banning of gag rules that prevent pharmacists from alerting patients when it would be cheaper to buy a prescribed drug without going through their insurance coverage, as well as moving certain drugs from Medicare Part B to Medicare Part D to improve the government’s ability to negotiations for lower prices.