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News & Press: General Announcement

Federal Effort Proposed to Lower Drug Prices

Monday, May 14, 2018   (0 Comments)
Posted by: David Walls
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On May 11th, the White House released, American Patients First, the Trump administrations blueprint to lower drug prices and reduce patient out-of-pocket costs. Below is the blueprint in brief as outlined in the report. You can find the full 44-page blueprint here.


American Patients First - Blueprint in Brief


Increased Competition

Immediate Actions

• Steps to prevent manufacturer gaming of regulatory processes such as Risk Evaluation and Mitigation Strategies (REMS)

• Measures to promote innovation and competition for biologics

• Developing proposals to stop Medicaid and Affordable Care Act programs from raising prices in the private market


Further Opportunities

• Considering how to encourage sharing of samples needed for generic drug development

• Additional efforts to promote the use of biosimilars


Better Negotiation

Immediate Actions

• Experimenting with value-based purchasing in federal programs

• Allowing more substitution in Medicare Part D to address price increases for singlesource generics

• Reforming Medicare Part D to give plan sponsors significantly more power when negotiating with manufacturers

• Sending a report to the President on whether lower prices on some Medicare Part B drugs could be negotiated for by Part D plans

• Leveraging the Competitive Acquisition Program in Part B.

• Working across the Administration to assess the problem of foreign free-riding


Further Opportunities

• Considering further use of value-based purchasing in federal programs, including indication-based pricing and long-term financing

• Removing government impediments to value-based purchasing by private payers

• Requiring site neutrality in payment

• Evaluating the accuracy and usefulness of current national drug spending data

• Investigating tools to address foreign government threats of compulsory licensing or IP theft that may be harming innovation and development, driving up U.S. drug prices


Incentives for Lower List Prices

Immediate Actions

• FDA evaluation of requiring manufacturers to include list prices in advertising

• Updating Medicare’s drug-pricing dashboard to make price increases and generic competition more transparent


Further Opportunities

• Measures to restrict the use of rebates, including revisiting the safe harbor under the AntiKickback statute for drug rebates

• Additional reforms to the rebating system

• Using incentives to discourage manufacturer price increases for drugs used in Part B and Part D

• Considering fiduciary status for Pharmacy Benefit Managers (PBMs)

• Reforms to the Medicaid Drug Rebate Program

• Reforms to the 340B Drug Discount Program

• Considering changes to HHS regulations regarding drug copay discount cards


Lowering Out-of-Pocket Costs

Immediate Actions

• Prohibiting Part D contracts from preventing pharmacists’ telling patients when they could pay less out-of-pocket by not using insurance

• Improving the usefulness of the Part D Explanation of Benefits statement by including information about drug price increases and lower cost alternatives


Further Opportunities

• More measures to inform Medicare Part B and D beneficiaries about lowercost alternatives

• Providing better annual, or more frequent, information on costs to Part D beneficiaries



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