How to limit drug prices

HHS RECEIVED over 3,000 comments on the Trump administration's Blueprint to Lower Drug Prices, which was released in May. Hospitals, health insurers and drugmakers had plenty to say on how to address soaring drug prices. Here are some edited excerpts from those comments.

HEALTH SYSTEMS

ASCENSION The Food and Drug Administration should create an accelerated pathway to bring generics to the market. There is already a similar pathway for new drugs. This would ensure competition and keep prices down. (Editor’s note: Ascension is part of a consortium of providers creating a generic-drug company.)

BAYLOR SCOTT & WHITE HEALTH Create an out-of-pocket spending limit on Part D plans for Medicare beneficiaries, and eliminate costsharing for generic and biosimilar drugs. Out-of-pocket spending for patients at the pharmacy and other sites of care have had the unfortunate side effect of increasing medical resource utilization for patients not taking their needed medications.

HENRY FORD HEALTH SYSTEM Creating stronger liability protections for drug manufacturers for rare adverse events could lower drug prices. Drug companies can and should be liable for known or predictable harms that were not disclosed during FDA review, but should not be liable for adverse events that were not detected in clinical trials because of their rare nature.

DRUG COMPANIES

AMGEN CMS should not move drugs covered under Medicare Part B to Part D, because doing so could severely disrupt patient access.

GILEAD Launch a subscription model in Medicaid for curative therapies. This is an approach that would allow Medicaid to pay an upfront annual fee, based on expected annual patient volumes, for an unlimited number of patients over multiple years.

SANOFI Create a new safe harbor for value-based arrangements in which drug payment is based on outcomes. Such a safe harbor should protect services that are aimed at encouraging better clinical outcomes, and new and emerging technologies that complement treatment.

HEALTH INSURERS

AETNA Don’t end drug rebates. Savings that health plans achieved through them will be lost—leading to higher prices.

ANTHEM Drug manufacturers should include list price in their advertisements. This is a critical detail that consumers need in order to make informed choices. HUMANA Permit Medicare Advantage plans to perform prior authorization for Part B Drugs. Medicare could save as much as 23% on immunology drugs like Remicade, Stelara, Simponi in 2019 if the idea were adopted.