The rule of Trump problems to demand the price of drugs in television commercials, thus rejecting the plan of the industry

The Trump administration decided on Monday to compel drug manufacturers to disclose their prices in consumer ads, just hours after qualifying the pharmaceutical industry 's transparency plan. inadequate.

HHS said its proposed rule fulfilled another part of the president's plan to reduce pharmaceutical costs and help Americans make more informed decisions that can reduce direct costs and those of government health programs such as Medicare and Medicaid. . This decision came with polls showing that voters were outraged by the cost of drugs, which is also an increasingly important part of the federal budget.

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The agency said studies have shown that increased price transparency would deter manufacturers from raising prices.

The proposed rule would require manufacturers to quote the monthly wholesale price of a product or the cost of a typical treatment if it is greater than $ 35 per year for 30 days. The information should appear in a text large enough for people to read. The ads should also include a statement stating that patients with health insurance can pay a different amount.

PhRMA, which argues that catalog price disclosure without other context is misleading to consumers, is strongly opposed, as most of them have insurance that allows them to negotiate lower costs and do not cost to the consumer that a fraction of the catalog price of a drug. The industry worries about disclosure of the highest catalog prices that could deter patients from seeking medical care.

PhRMA is committed today to using its TV commercials to direct consumers to more nuanced information about the cost of a drug.

PhRMA member companies will not publish price information directly in their ads, but instead will indicate where patients can find more information about the cost of their medications, such as a website. The website would include the current price of the drug, an expected range of potential costs for patients, and available financial support to help consumers pay for their medications.

The PhRMA plan, which would come into effect on April 15, was quickly criticized by HHS secretary Alex Azar, who said it was not going far enough.

"Current prices are important for American patients, and I have heard it personally and the president, too," Azar told the National Academy of Medicine in a speech highlighting the government's proposal.

HHS indicates that the price displayed is relevant to patients before their deductible is deductible from their insurance plan, or in cases where the drug is not covered by a plan. The price displayed can also determine the percentage of the cost of a drug that the consumer will pay.

The drug industry has spent more than $ 5.5 billion on advertising in 2017, including nearly $ 4.2 billion in television advertising, according to HHS.

The PhRMA indicated that it was likely that the administration plan would be challenged in court under the first amendment.

"The problem is that if the government forces companies to speak, it breaks the first amendment," said PhRMA's general counsel James Stansel, announcing the counterproposal of his sector this morning.

HHS is not discouraged by the potential threat. Its proposed regulation provides a defense of policy under the First Amendment.

HHS stated that the price disclosure was consistent with Supreme Court decisions in the First Amendment in the past, noting that the courts had upheld the disclosure of the factual information requested by the companies when the disclosure concerned a government interest It was not too heavy.

The rule is focused on TV commercials because it is in this area that the Supreme Court has recognized that the government could take special measures to ensure that consumers receive the appropriate information.

"Taking steps to protect consumers from opaque prices is far from unprecedented," Azar said, noting that a similar requirement had been put in place for car ads. for over 60 years – another company where people often pay below the advertised price.

"People still benefit from discounts, but sticker prices are considered an important piece of essential information for the consumer.There is no reason for the drugs to be different. from time to time, but millions of Americans buy expensive drugs each month. "

Although Congress did not explicitly authorize the HHS to publicly price the current price of drugs, the HHS believes that it may require the disclosure of data because Congress has ordered it to operate Medicaid effectively and Medicare.

Advertising "may … lead to increased use by patients who demand expensive advertising-based medicines and biologics, resulting in increased public spending – a problem if cheaper alternatives are available, or would be the result of market pressures resulting from price transparency ", states the proposed rule.

The majority of voters tend to support the movement for transparency, but remain skeptical about whether this will lead to a reduction in drug costs.

A POLITICO / Harvard survey in July found that 63% of Americans supported the requirement for drug advertisements to include price information, but only 28% thought it would result in lower costs.

Health policy experts also say price disclosure will not likely change the cost of drugs.

"Transparency did not have the effect of lowering the price of drugs in the long run and there is no reason to believe that it would work here," said Rachel Sachs, Washington's health policy attorney University in St. Louis..