(Bloomberg) -- President Donald Trump’s plan to tackle high drug prices relies on policies that can be implemented fairly soon as well as many the administration wants to take time to explore, or needs help from Congress to implement.
Here’s a breakdown of some of the top proposals:
Needs Study or Legislation
|Prohibit “gag clauses” insurers use to prevent pharmacists from telling patients when they could pay less for a drug without using their insurance.||Look into reducing or eliminating the drug supply chain’s reliance on rebates pharmacy-benefit managers negotiate in secret with drug companies.|
|Allow Medicare Part D plans to adjust coverage mid-year if a generic drug made by only one company increases its price.||Congress could implement policies Trump previously proposed, including capping seniors’ out-of-pocket spending on drugs in Medicare, or requiring discounts negotiated by drug plans to be shared with seniors at the pharmacy counter.|
|Direct the Food and Drug Administration to evaluate requiring drugmakers to state their list prices in direct-to-consumer advertisements.||Explore whether government health programs should pay different prices for the same drug, depending on the condition a patient is taking it for. Drugs can be approved to treat several diseases but have different levels of effectiveness for different conditions.|
|Develop “value-based” pilot projects in Medicare to test arrangements that would pay drugmakers based on how well a drug works.||Review the Medicare Part B program that pays for drugs administered by hospitals and in doctors offices to identify drugs that could have their prices negotiated by pharmacy-benefit managers like CVS Health Corp. and Express Scripts Holding Co.|
|Use the federal government’s bully pulpit to hold drugmakers accountable for large increases and highlight companies that didn’t raise prices.||Consider whether pharmacy-benefit managers should be designated as fiduciaries required to act in the best interests of the people paying them.|
|Develop policies to improve price transparency: Health and Human Services Secretary Alex Azar told CNBC the day will come when a doctor will write a prescription and be able to tell a patient what they will pay.|
|Re-examine the 340B prescription drug discount program for hospitals that treat a large number of poor patients, including whether eligibility in the program needs to be changed.|
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