October 18, 2018

Pharmaceutical prices in TV ads – but when and how? 

Last Monday, PhRMA announced that they were encouraging their members to add cost information to the Direct To Consumer (DTR) advertising of their products. In 1985, the FDA agreed to allow television advertising of pharmaceuticals. New Zealand is the only other country to allow this. US research indicates that “Since 2012, spending on drug commercials has increased by 62%, and $5 billion were spent on drug commercials last year.”

PhRMA is developing a website (scheduled to go live in early 2019) that will feature information on the pubic cost and pricing of their members’ products. This commitment, however, may not be sufficient to meet the demands of the Trump administration.

Also last Monday, Politico reports,the Department of Health and Human Services (DHHS) announced they will be “moving forward with a proposed rule to require pharma to include list prices in direct-to-consumer ads”. DHHS spokeswoman Caitlin Oakley observed that, “While we cannot comment on pending regulations, the President’s ‘American Patients First’ blueprint to lower prescription drug prices and reduce out-of-pocket costs clearly states that HHS is looking at options to require drug pricing transparency. It should not come as a surprise that this would require rulemaking.”  DHHS Secretary Alex Azar, commenting on the PhRMA press release later in the day, said “We will not wait for an industry with so many conflicting and perverse incentives to reform itself.”

According to Kaiser Health News, the new federal rule will require pharmaceutical companies to include in their advertising, “the price of any drug that cost more than $35 a month.” It further stipulates that the price should appear in “a legible manner,” and “presented against a contrasting background in a way that is easy to read.”

Seeing price information clearly listed in an advertisement on the screen or in a magazine is very different from being directed during an ad to a website where the price information will be posted (as PhRMA is offering). The latter will, obviously, reach far fewer consumers.

Kaiser further reported, however, that DHHS has no enforcement mechanism to make companies comply with their directive about price listing, beyond their threat to “post a list of companies violating the rule… and depend on the private sector to police itself with litigation.”  

Arkansas Removes Another 4100 Recipients from Medicaid

For the second month in a row, Arkansas has dropped over 4000 residents from their Medicaid rolls. The state Department of Human Services (DHS) announced last Monday that 4100 recipients were being removed in October, following the removal of 4353 members from the program in September.

Associated Press reports that these members are losing their health insurance due to their failure to comply with new work requirement rules implemented early this year. A total of 76,000 Arkansans on Medicaid are categorized as able-bodied and, thus, required to work at least 80 hours per month to keep their coverage. According to Kaiser Family Foundation, they “must report their work or exemption status using an online portal.”  This is a major roadblock given that many recipients do not have a computer and/or sufficient internet access (see WA 9/20/18 for more on this).

Arkansas’ DHS projects that “another 4,800 people will lose coverage if they don’t meet the work requirement by the end of this month,” AP reports.

Last July,U.S. District Judge James Boasberg blocked Kentucky from implementing its similar work requirement program on the grounds that it failed to respond to the intent of the Medicaid program, which is to provide health coverage. For this reason, he ruled, it was “arbitrary and capricious”.  Ironically,Judge Boasberg has now been assigned to hear a case brought against the state of Arkansas on the same grounds. U.S. Department of Justice attorneys have asked Judge Boasberg to turn down the assignment. Stay tuned!

Easy-to-use “Public Charge” Fact Sheet

In the 9/20/18 issue of this column, we outlined the “Public Charge” regulation proposed by the Department of Homeland Security that is already causing non-citizens in our country to avoid using public services – including public health clinics – for fear of being labeled a “Public Charge” and deported.

You can access a helpful fact sheet here. We suggest that you share it with your staff and patients, if relevant. Providing this information may help clarify the provisions of the proposed regulation and, thus, reduce anxiety levels among people who are not citizens. Additional information can help all of us to support their rights and health needs in this difficult time.  Thanks!!

View the latest Policy Update here.