TV Ads for Drugs Must Show Prices

TV Ads for Drugs Must Show Prices

To help drive drug prices down, the Centers for Medicare & Medicaid Services (CMS) will require direct-to-consumer television advertisements for prescription drugs covered by Medicare or Medicaid to include the list price – the Wholesale Acquisition Cost – if that price is equal to or greater than $35 for a month’s supply or the usual course of therapy, according to a new Final Rule.

Patients Pay All for Drugs

“Patients have the right to know the prices of healthcare services, and CMS is serious about empowering patients with this information across-the-board,” said CMS Administrator Seema Verma. For the forty-seven percent of Americans who have high-deductible health insurance plans, CMS said, the price they see in ads essentially is the price they pay, until they meet their deductible. List prices are also what patients pay if a drug is not on their insurance formulary. All seniors on Medicare Part D have coinsurance for certain types of drugs, which means their out-of-pocket expenses are calculated as a share of list price.
The blueprint to bring down prescription drug prices laid out four strategies for solving the problems patients face: boosting competition, enhancing negotiation, creating incentives for lower list prices, and bringing down out-of-pocket costs.
Up until now, drug companies were required to disclose the major side effects a drug can have—but not the effect that buying the drug could have on your wallet, CMS said in a press release.
List prices matter to patients, many of whom either pay the list price or prices based on the list price.

Brad Ericson
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Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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