4 Drug Pricing€¦ · increases 30 days in advance when drugs that cost ... •Requires...

#NOH18@MikeAmeryDC@DerekBrandtDC@AANMember©2018 American Academy of Neurology

Support Drug Pricing Transparency


New Issue Training Format• Issue background• Ask• Q&A with panel• Demonstration of ask• Practice on your own in small groups•Wrap up


Drug Pricing Landscape


Neurology Stake in Drug Pricing

Rare Diseases

Medicines in Development

Physician Population2%

11%

18%


Prices On the Rise• $325 billion spent on prescription drugs in 2015$45.5 billion in out-of-pocket expenses for patients

• 50% of Americans use at least one prescription drug

• 25% of Americans report difficulty paying for prescriptions


US Costs Higher Than Abroad


Outlook – More Rx Spending• US spends more than any other country in both

total spending and spending per person

• Spending expected to grow to $610 billion by 2021, a 53% increase from 2015


Drug Pricing Activity in 2017• 1,025 bills in state legislatures

• 19 bills in Congress

• Engagement from federal agencies

• Active pharmaceutical development


Impact of High Drug Costs

Health System Spending

Physician/ Institution Attribution

Patient Access/Out of Pocket

Cost


Impact on Patients• Nearly 1 in 4 Americans taking prescription drugs

report difficulty affording them• Prescription abandonment• Compliance difficulty, including rationing • Patients share of costs has increased Particularly disproportionate impact for those taking specialty drugs


Impact on Physicians/Institutions• High cost drugs = high institutional risk• The cost of drugs prescribed is attributed to the

prescriberNarrow networksMIPS adjustments–2018: Cost is 10% of total score–2019+: Cost could be up to 30% of total score

• Unfavorable for risk-bearing APMs • Prior authorization/office burden


FAIR Drug Pricing Act (S.1131/H.R.2439)• Requires drug manufacturers to report price

increases 30 days in advance when drugs that cost $100 or more increase in price by more than 10% in 1 year or 25% over 3 years

• Requires justification for price increases and reporting on research, marketing, spending, etc.

• Does not prohibit price increases; simply adds requirement for notification and justification


The Ask

Cosponsor the Fair Accountability and Innovative Research (FAIR) Drug

Pricing Act (S.1131/H.R.2439) and support drug pricing transparency


Related Bills• Transparent Drug Pricing Act (H.R.4116)• Prescription Drug Price Transparency Act (H.R.1316)• Improving Access to Affordable Prescription Drugs

Act (S.771/H.R.1776)• Stopping the Pharmaceutical Industry from Keeping

Drugs Expensive (SPIKE) Act (S.1348)


Frequently Asked Questions•Who would enforce this legislation?US Department of Health and Human Services

•Who else supports this legislation?National MS Society, AARP, Campaign for Sustainable Drug Pricing, Kaiser Permanente, Marshfield Clinic

• Are these requirements realistic?Many manufacturers have already limited year-over-year price increases to 10% or less from 2017-2018


Questions?


Example Ask


Practice the Ask in Your Small Groups


Develop Your Pitch• Share your storyTalk about how high drug prices impact one of your patients

• Practice your story linking to the ask• Tell your story + “…that’s why we’re here today

asking for your support. We’d like you to cosponsor legislation, S.1131/H.R.2439, to support much needed drug pricing transparency.”


Final Thoughts

4 Drug Pricing€¦ · increases 30 days in advance when drugs that cost ... •Requires...

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