Washington, D.C. – Today U.S. Senators Catherine Cortez Masto (D-Nev.), John Cornyn (R-Tex.), Tom Carper (D-Del.), and Bill Cassidy (R-La.) introduced drug pricing transparency legislation. This bill allows the Medicare Payment Advisory Commission (MedPAC) as well as the Medicaid and CHIP Payment Advisory Commission (MACPAC) access to critical information on pricing and contracts under Medicaid and Medicare.
“One of the things I hear from Nevadans every day is the challenges they face affording their prescriptions,” said Senator Cortez Masto. “My legislation ensures that we have patient-centered pricing by requiring prescription drug manufacturers, and other private health companies, to provide Congressional advisory agencies with data on how they set their prices and manage their contracts. Sharing this information will provide the critical data we need to address exorbitant out of pocket costs on seniors and taxpayers, as well as hold prescription drug companies accountable. It’s time for transparency so that American taxpayers, and recipients of these crucial programs are no longer left in the dark.”
“The sky rocketing price of prescription drugs and the lack of transparency in pricing has made life-saving medications unaffordable for many Texans,” Senator Cornyn said. “This bill will help Congress hold prescription drug companies, PBMs, and other middlemen accountable so we can ensure drug pricing is patient-centered.”
“Time and again, I hear from Delawareans who simply cannot afford the life-saving medications that they need,” said Senator Carper. “Since 2011, Medicare payments for brand-name drugs have increased by more than 60 percent. In 2015, over one million seniors who are enrolled in Medicare D paid more than $3,000 for life-saving drugs on an average annual income of $30,000. This is simply unacceptable. Today, I’m proud to introduce a bill that ensures greater transparency in drug pricing by requiring manufacturers and pharmacy benefit managers to provide Congressional agencies with critical information they need to address increasing costs. This bipartisan bill is an important step in our fight to lower prescription drug prices for seniors, families and taxpayers.”
“To fix our health system, we need solutions that increase price transparency and leverage the power of patient choice to lower the cost of care,” said Dr. Cassidy. “While there’s no silver bullet that will lower all drug costs, there is silver buckshot. This legislation creates the transparency we need to find those solutions to lower the price of prescription drugs.”
BACKGROUND:
One of the greatest challenges to understanding and counteracting rising out of pocket drug costs is the lack of transparency in how pharmacy benefit managers (PBMs) negotiate discounts from manufacturers on behalf of health plans. This lack of data creates problems for Congress when crafting policy related to prescription drugs. Allowing for the disclosure of this data allows the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment Advisory Commission (MACPAC) to make better informed recommendations on how Congress can navigate the drug supply chain, address costs and ensure patient-centered pricing.
The bill introduced by Senators Cortez Masto (D-Nev.), Cornyn (R-Tex.), Carper (D-Del.) and Cassidy (R-La.) will help the nonpartisan Congressional agencies, MedPAC and MACPAC to analyze access to care, quality of care, and other issues related to prescription drug coverage under Medicare and Medicaid. These agencies offer biannual reports and proposals to improve federal health programs, which are often adopted into legislation.
Current law requires entities including pharmacy benefit managers, insurance carriers, wholesalers and drug manufacturers engaged in contracts to offer Prescription Drug Plans under Medicare part D, Medicare Advantage plans under Medicare Part C, or coverage under Medicaid to disclose certain contractual information to the government to inform oversight, evaluation and enforcement. This bill makes that information available to MedPAC and MACPAC. These agencies would be able to use the information to monitor, analyze and make recommendations to Congress on how best to reduce out of pocket prescription drug costs.
Full text of the bill is available here.