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April 23, 2019

More drugmakers are posting their list prices online

Daily Briefing

    About a dozen drugmakers for the first time have posted their prescription drug prices online, but experts are not convinced the new information will help patients have a better understanding of their drug costs.

    Learn 5 ways to control the flow of drug expenditures

    Background: HHS proposes requiring drugmakers to disclose prices in ads

    HHS in October 2018 proposed a rule that would require prescription drugmakers to include product list prices in their direct-to-consumer (DTC) TV ads. Trump administration officials said they hope increasing transparency of prescription drug prices will foster a more competitive marketplace that encourages drugmakers to lower their prices. The proposed rule currently is under review by the White House's Office of Management and Budget (OMB), which is the final step before a rule is finalized.

    But industry stakeholders and some experts have argued that including list prices in drug ads could confuse patients. Pharmaceutical Research and Manufacturers of America (PhRMA) President Steve Ubl said requiring drugmakers to disclose medications' list prices in ads would be "very confusing, misleading, lac[k] appropriate context, and isn't what patients want or need." He explained that those prices would not reflect what most patients would actually pay for the drugs, and instead could deter patients from seeking care. As such, PhRMA in October 2018 said its members by April 15 would voluntarily begin directing consumers to company websites with more detailed pricing information instead of directly including the prices in the ads.

    Eli Lilly, which is a member of PhRMA, in January began posting online pricing information for drugs it advertises on television. The following month, Johnson & Johnson (J&J), which is also a PhRMA member, announced plans to begin disclosing the list prices of its prescription drugs in television advertisements.

    More drugmakers begin disclosing drug prices online

    Nearly a dozen drugmakers now are disclosing drug pricing information online, including:

    • AbbVie;
    • Amgen;
    • AstraZeneca;
    • Astellas;
    • Bristol-Myers Squibb;
    • Gilead Sciences;
    • GlaxoSmithKline (GSK);
    • Pfizer;
    • Sanofi; and
    • Takeda.

    Some of the drugmakers, including Amgen and Pfizer, have launched new websites that patients can use to access pricing information for several drugs. Other drugmakers, including Bristol-Myers Squibb and Sanofi, have updated existing websites for their drug products to include list prices. For example, AbbVie has added pricing information to Humira's website.

    Drugmakers' cost info varies

    STAT News reviewed several of the websites and found that both the new and updated sites show how a number of factors can affect the prices patients pay for their prescription drugs. For example, GSK's website provided an explanation on how drug costs are determined for Medicare beneficiaries, and broke down the four phases of Medicare drug coverage and how each affects a patient's out-of-pocket costs, STAT News reports.

    But not all drugmakers included explanations on how insurance coverage affects a patient's out-of-pocket costs, STAT News reports. For example, Takeda and Lundbeck did not mention Medicare coverage on their drug pricing website for their antidepressant Trintellix.

    Many of the websites included information on options for patients who are not able to cover the cost of a drug, STAT News reports. For instance, Takeda and Lundbeck included a graphic on their website stating that patients "can pay as little as $10" for Trintellix by using a copayment coupon, though Medicare patients are not able to use such coupons, STAT News reports.

    According to STAT News, drugmakers also took different approaches toward displaying drugs' list prices. For example, Astellas' website showed the list price of its overactive bladder drug Myrbetriq is $12.81 per day, instead of listing the drug's annual cost of $4,675. In addition, STAT News found Pfizer's website stated that 52% of commercially insured patients pay less than $20 for its rheumatoid arthritis drug Xeljanz, but toward the bottom of the website, the drugmaker noted that 14% of patients pay an average of $1,167.47 for the drug.  

    In contrast, J&J's website prominently showed the list price of its Crohn's disease drug Stelara is $11,000 per month, but emphasized most patients pay less than $5 a month for the drug, STAT News reports.

    Experts say price disclosures might be confusing for patients

    Health care experts have said they expect patients will likely have trouble navigating the "patchwork quilt of resources" available on drug prices, Bloomberg reports. 

    Connecture Senior Vice President Jim Yocum, who manages's price-transparency tools, said, "If your aim is transparency, those prices need to be upfront and not require additional action from the patient." Yocum said requiring patients to "click through a website" can "obscure" a drug's price. He added that he expects the White House will continue to push for drugmakers to include list prices in TV ads.

    However, Jon Bigelow, executive director of the Coalition for Healthcare Communication, said, "It's notable that … the pharmaceutical companies have taken a constructive approach to find ways to present pricing information to consumers in a useful way" (Owens, "Vitals," Axios, 4/19; Griffin/Edney, Bloomberg, 4/18; Florko, STAT News, 4/17). 

    Learn 5 ways to control the flow of drug expenditures

    Prescription drug expenditures are the fastest growing component of health care spending. And while reducing unwarranted prescribing variation is the single biggest improvement opportunity, there are several other near-term chances to reduce spending and grow revenues.

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