ISSUE EDUCATION & LEGISLATION
The nation’s drug pricing system is broken and old ideas won’t work.
As a unique group of experts who have dedicated our lives understanding pharmacy and prescription prices and policies, we know this doesn’t have to be reality.
What’s demanded are fresh ideas advancing access to cheaper prescription prices now for patients and consumers.
In fact, in our view, reduced drug costs, are in many ways hidden from view—by unnecessary approaches which stifle technology and impede competition driving up the cost of medicine for patients and plans.
Our focus: Making drug price transparency a national priority today
Transparency-Rx’s priorities reflect the diverse points of view of our healthcare, pharmacy community and their appetite for social good. Our issue-based work advances:
True prices:
Whether drug negotiation occurs under Medicare, through other means, or in the private sector, what is clear is neither will work fairly or adequately, unless and until there’s a ledger of “true price.” True drug prices should not be hidden, but disclosed and shared by the physician, patient, plans, pharmacy, PBM and carrier.
A level playing field ending conflicts of interests:
Often driven by special interests, status quo contracting requirements often exclude innovation and entrench the profits of big insurers and traditional monopoly PBMs. Moreover, PBMs shouldn’t win when drug prices go up or by forcing seniors and consumers to the most expensive and profitable drugs in their own affiliated pharmacies. PBMs should win based on their quality of service and investment for care for patients and plan. Policymakers should increasingly support fair competition, advancing wider use of transparent purchase agreements, eliminating conflicts of interests, and deterring side deals with drug-makers.
Ending information and data blocking:
Increasingly big insurers and large PBMs are closing markets and stymie competition by “unplugging” transparent PBMs from crucial networks or opportunities. A fair marketplace should reflect the robust sharing of data, which provide the backbone of affordable prescription drug pricing, restrictions on carve-out penalties and an overall basis for real competition.
Increasing and enforcing disclosure fairly:
By preserving the rebate rule and pushing for disclosure of all manufacturers derive revenues paid to industry insiders, cost shares will become known and a basis for significant and shared shavings to consumer, seniors, community pharmacists, plans and patients. Abusive PBM practices that undercut implementing a transparent drug pricing model in Medicare Part D, private insurance and elsewhere, and securing innovation and savings in Medicaid managed care which prohibits spread pricing, will remain a center of attention.
IMPORTANT LEGISLATION
Empowerment through transparency is just the start.
Greater integrity renews trust and access and will fundamentally reduce spending and costs, but there’s more to our mission. It’s why Transparency-Rx is acutely focused on:
- Invigorating public benchmarks for drug costs at the point of acquisition
- Strengthening US supply chains, accelerating ingenuity and modernizing delivery to improve medical outcomes and addressing drug shortages
- Supporting public health, drug abuse mitigation through improved data sharing and partnerships to treatment providers
