Prescription Drugs

ACHP is dedicated to tackling the high cost of prescription drugs to ensure a sustainable health care system that works for patients and health plans alike. We have long been committed to increased transparency in drug pricing to help foster competition in the marketplace and help consumers make better choices about their health care. We believe that transparency, including the disclosure of research and development costs for drug manufacturing, is a critical first step in creating a competitive and effective pharmaceuticals market.

Letter to Senate HELP Committee Chair Lamar Alexander on Lowering Health Costs, February 2019
ACHP response to CMS proposal to lower drug prices and reduce out-of-pocket expenses in Part D and Medicare Advantage, January 2019
ACHP comment on Trump Administration plan for drug pricing transparency, December 2018
ACHP response to Trump Administration’s RFI on drug pricing blueprint, July 2018
ACHP response to Trump Administration proposed rule on Medicare Advantage and Part D, January 2018
ACHP response to Trump Administration proposal requiring drug pricing transparency, December 2017
Letter to Senate HELP Committee on rising cost of prescription drugs, June 2017
HFMA column on skyrocketing prescription drug costs, August 2017

The Spike in Drug Prices: Infographic Series
ACHP’s infographic series highlights drug cost trends for widely prescribed drugs to help educate consumers and stakeholders about the impact of high prices. Past graphics have detailed the rising cost of generics, as well as treatments for high cholesterol, rheumatoid arthritis, and multiple sclerosis. For more information, see here

Increasing Transparency in Drug Pricing

ACHP supports the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act of 2017, introduced by Senators John McCain and Tammy Baldwin. The bill would bring much needed transparency to how prices are set by pharmaceutical companies – mandating that manufacturers disclose information about price increases and requiring reporting of R&D costs. It would also require drug manufacturers to provide a 30-day warning to HHS before increasing the price of certain drugs and include justification and data for each increase.

Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals, April 2019
Support for FAIR Drug Pricing Act of 2017, May 2017
Support for FAIR Drug Pricing Act of 2016, September 2016

Fostering a Competitive Marketplace

ACHP has pushed for legislation that fosters competition and encourages the market entry of lower-cost pharmaceuticals. Congressional action on the FDA Reauthorization Act of 2017 was critical to providing the FDA the necessary resources to review the safety of generic and bio-similar products in a timely manner and help clear up the generic drug application backlog – fostering competition in the marketplace and helping alleviate drug shortages. Two of ACHP’s recommendations on expediting approval for generic drugs and closing the orphan drug loophole were included in the bill. Streamlining FDA’s drug approval process would also help ensure affordable alternatives are readily available. In addition, ACHP supports the bipartisan CREATES Act, which discourages anticompetitive behavior by drug companies and removes barriers to competition.

Support for CREATES Act, February 2018

ACHP leading the way

Health plans are partnering with provides to help consumers find affordable treatments. Capital District Physicians Health Plan in Albany, N.Y., is employing pharmaceutical sales representatives to educate providers on the cost of medications and the most effective and affordable treatments. In one case, the efforts have resulted in providers prescribing a generic alternative and saving nearly $5 million in one year. Health plans are also making online tools available to help patients shop for the best medications at the best price. HealthPartners in Minneapolis, M.N., is partnering with GoodRx to provide patients real-time prices and out-of-pocket costs, based on their benefits. The calculator also shows consumers the cost to the health plan. By choosing the lowest cost option, consumers save money on the front end and help lower their health plan costs in the long-run.

Capital District Physicians’ Health Plan takes a unique approach to tackling the high cost of prescription drugs. (Selling Doctors on Cutting Drug Costs; New York Times; June 6, 2017)

Q&A: Health plan executives discuss high drug prices (Managed Healthcare Executive, October 2015) – Featuring John Bennett, MD, of Capital District Physicians’ Health Plan, and Patricia Richards of SelectHealth

Health plan CEOs: Prescription drugs post major cost concerns (FierceHealthPayer, October 2015) – Featuring John Bennett, MD, of Capital District Physicians’ Health Plan, and Patricia Richards of SelectHealth

Reform Update: Generic drugs’ high prices spur fears of failed drug adherence (Modern Healthcare, October 2014) – HealthPartners, Group Health Cooperative of South Central Wisconsin and Independent Health discuss health plan strategies to address the rising cost of generic drugs.