AMA del­e­gates will de­bate ways to curb drug prices

Modern Healthcare - - THE WEEK AHEAD - —Har­ris Meyer

Curb­ing the growth of pre­scrip­tion drug prices will be a ma­jor fo­cus this week when the Amer­i­can Med­i­cal As­so­ci­a­tion’s House of Del­e­gates gath­ers in Chicago for its an­nual meet­ing.

There un­doubt­edly will be lots of dis­cus­sion among the hun­dreds of del­e­gates about con­gres­sional Repub­li­cans’ on­go­ing ef­forts to re­peal and re­place the Af­ford­able Care Act. The na­tion’s largest physi­cian’s group blasted the House GOP re­peal bill on the grounds that it would cause mil­lions of Amer­i­cans to lose health cov­er­age and weaken in­sur­ance pro­tec­tions for peo­ple with pre-ex­ist­ing con­di­tions.

Many physi­cians re­port in­creas­ingly hear­ing from their pa­tients that they can’t af­ford their med­i­ca­tions, and say this is af­fect­ing med­i­ca­tion ad­her­ence and out­comes of treat­ment.

Driven by that re­al­ity, the AMA del­e­gates will con­sider half a dozen res­o­lu­tions ad­dress­ing drug prices. They in­clude mea­sures to in­crease pric­ing trans­parency; strengthen en­force­ment against goug­ing; re­quire drug­mak­ers to dis­close prices in direct-to-con­sumer ad­ver­tis­ing; set an $500 monthly out-of-pocket cap for drug costs in health plans; in­cor­po­rate es­ti­mated out-of-pocket drug costs in elec­tronic health records; and let the CMS ne­go­ti­ate prices with man­u­fac­tur­ers.

The AMA, which claims about 230,000 mem­bers, has un­suc­cess­fully lob­bied Congress to ban direct-to-con­sumer drug ads en­tirely. Po­lit­i­cal ob­servers say sig­nif­i­cant con­gres­sional ac­tion on drug prices is un­likely this year, given the GOP fo­cus on Oba­macare re­peal and tax cuts plus the deep pock­ets of the phar­ma­ceu­ti­cal in­dus­try.

No ma­jor changes are pro­posed in the AMA’s po­si­tion on ex­pand­ing health in­sur­ance cov­er­age un­der the Af­ford­able Care Act, which the as­so­ci­a­tion reaf­firmed late last year. That stance re­mains con­tro­ver­sial among con­ser­va­tive doc­tors, while the AMA’s sup­port for the con­fir­ma­tion of Dr. Tom Price as HHS sec­re­tary—a strong Oba­macare foe—re­mains a sore point with lib­eral doc­tors.

“Our po­si­tion is that peo­ple who don’t have in­sur­ance should get it, and those who have it shouldn’t lose it,” AMA Pres­i­dent Dr. An­drew Gur­man said in an in­ter­view. “Those with­out health in­sur­ance live sicker and die younger.”

Dr. David Barbe, a fam­ily physi­cian from Moun­tain Grove, Mo., will be in­au­gu­rated as the AMA’s new pres­i­dent dur­ing the meet­ing.


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