WASHINGTON – The ads urging people to ask their doctors to prescribe new drugs that can tackle a host of hard-to-treat conditions — from arthritis to hepatitis C — are ubiquitous on both television and in print.
What isn’t as obvious is how much these drugs actually cost.
Last week the U.S. Senate gave consumers – along with doctors, hospitals, and Connecticut’s health insurers — a win by approving bipartisan legislation that would require this “direct-to-consumer” advertising to include the price of these medications, which are among the costliest on the market.
The Senate-approved measure would provide the Department of Health and Human Services with $1 million to implement proposed Trump administration rules that would require the disclosure by drug makers.
HHS Secretary Alex Azar has pushed for the disclosure in press briefings and in congressional hearings, while FDA Commissioner Scott Gottlieb has indicated that an agency working group will soon begin work on proposed rules.
The amendment’s sponsors, Sens. Chuck Grassley, R-Iowa, and Dick Durbin, D-Ill., have touted the measure as a common-sense step toward greater transparency. The United States and New Zealand are the only two countries that allow direct-to-consumer drug advertising.
“Last year, the pharmaceutical industry spent more than $6 billion in direct-to-consumer advertisements, which drive up health care costs by steering patients toward more expensive, often unnecessary medications,,” Grassley said in a speech on the Senate floor last week. “The average American sees nine direct-to-consumer prescription drug ads each day.”
Grassley also said studies show that patients are more likely to ask their doctor for a specific brand-name medication, and doctors are more likely to prescribe one, when they have been marketed directly with drug advertisements.
But changing the rules of direct-to-consumer advertising is almost certain to generate substantial debate – and pushback from the politically powerful pharmaceutical and advertising industries, which are concerned the legislation will dry up a lucrative line of business.
Opponents of changing the rules have prevailed in the past.
For instance, in 2016, Rep. Rosa DeLauro, D-3rd District, introduced the “Responsibility in Drug Advertising Act,” which would impose a three-year moratorium on the advertising of newly approved prescription drugs directly to consumers.
The bill died with that Congress.
But last week’s Senate action has revived hopes by supporters of reform – and even abolition – of direct-to-consumer drug ads.
“Your amendment—by taking an important step toward disclosure of pharmaceutical pricing information—recognizes that greater transparency is a crucial ingredient of the broad-based strategy that is needed to put downward pressure on prescription drug prices,” said Matthew D. Eyles, president of American’s Health Insurance Plans, in a letter to Grassley and Durbin.
Eyles said the price of a prescription drug is “ driven entirely by the original list price of a branded drug—which is determined solely by the drug company, not by the market or any other participant in the pharmaceutical supply chain.” Eyles also said providing consumers with information on the cost of their medicines “is a crucial step toward greater transparency and accountability about the true costs to the system.”
The health insurance industry has for years mounted an aggressive campaign aimed at lowering the cost of prescription drugs, which affects its bottom line.
For instance, Health Affairs blog recently reported that Harvard Pilgrim Health Care, a company with about one million customers in Connecticut and three other New England states, had a 25 percent increase in its health care costs between 2011 and 2016 that was “largely due to increasing prices of specialty medications.”
Doctors also support the disclosure of the cost of drugs that are promoted in direct-to-consumer advertising. The American Medical Association, the largest organization representing doctors, called for a ban on direct-to-consumer ads in 2015.
Matthew Katz, CEO of the Connecticut Medical Society, cautioned that disclosure of drug prices on direct-to-consumer ads is only “a small step” in the right direction.
“Direct-to-consumer advertising itself is part of the problem that must be addressed,” he said.
Meanwhile, the pharmaceutical industry, represented by Pharmaceutical Research and Manufacturers of America, or PhRMA, says these ads provide consumers with valuable information, including increasing awareness about diseases, educating patients about treatment options and motivating patients to talk to their doctors about health concerns.
PhRMA has also developed voluntary guidelines for its members who participate in direct-to-consumer drug advertising.
Those include a commitment:
- To be accurate and not misleading
- To make claims only when supported by substantial evidence
- To reflect balance between risks and benefits, and
- To be consistent with the FDA-approved labeling
Approved as part of a larger spending bill, the Durbin-Grassley amendment gives the White House legislative backing in its efforts to curb the cost of prescription drugs. The amendment also signals that there is a willingness in Congress this year to tackle the issue.
The amendment is part of a broad spending bill that must be reconciled with a version in the House of Representatives b before it goes to the president’s desk.