The Clinical Divide: Promoting Drug Price Transparency Tools

Earlier this month, reports revealed that leading drug companies allegedly colluded to inflate generic drug prices by as much as 1,000%. A lawsuit filed by 43 states named 15 individual senior pharmaceutical executives responsible for sales. This behavior hurts everyone: hospitals, doctors and — most significantly — patients.

As you know, I’ve been a longtime advocate for leveraging technology for drug price transparency in order to provide consumers, or patients, with insight into how they are being charged with the hopes of ultimately getting them better deals on pharmaceutical purchases. Now, the Centers for Medicare and Medicaid Services (CMS) is proposing a new drug pricing transparency tool for Medicare Part D plans. So what is this rule and how can technology like this benefit our patients?

Welcome to The Clinical Divide. I’m Dr. Kevin Campbell. I’m a Duke-trained cardiologist and CEO of the health data startup PaceMate. Every week, this Inside Digital Health™ video series examines healthcare technology and medicine’s top news. I bring you the views that help physicians and healthcare executives bridge the clinical divide.

The new CMS rule we talked about would require Part D plans to adopt tools that provide clinicians with information they can use to discuss out-of-pocket costs for prescription drugs with patients. Part D plans would be required to provide access to a price transparency tool that is integrated into the electronic health record system. This is very ambitious, but the rule also requires that the Explanation of Benefits document that Part D enrollees receive each month includes information on drug price increases and on lower-cost therapeutic alternatives that work just as well.

The rule implements Part D legislation signed by President Trump to prohibit these “gag clauses” that you hear about. In the past, these shady backroom deals kept pharmacists from telling their patients and customers about lower-cost ways to obtain prescription drugs. This simply is not fair.

The hope is that patients and their physicians will better understand the cost of drugs and seek out high-value options to increase adherence and improve outcomes. When efficacy is equivalent, why should patients pay more just to fill the pockets of pharmaceutical executives?

As physicians and healthcare executives, we must push for more price transparency tools such as this one. We must urge our health systems to implement the technology to better our patients. It is essential that we give our patients all the tools they need so that they can make informed healthcare decisions. Those that abuse the system, such as those involved in this latest scandal, must be held accountable and prosecuted to the fullest extent of the law.

Thank you for joining me for this episode of The Clinical Divide. Until next week, I’m Dr. Kevin Campbell, for Inside Digital Health™.

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More Episodes of The Clinical Divide:

Leveraging Tech to Influence Drug Pricing Policy Change

Advocating for Fair Drug Pricing

Driving Organizational Change to Create Better Patient Experiences