Drug Price Transparency: Everything You Need to Know

Reviewed and Updated by Kelsey Davis,

Drug Price Transparency: Everything You Need to Know

The Henry J Kaiser Family Foundation estimates that $1 out of every $6 in Medicare spending is for prescription drugs. These medications play an important role in the health of 59 million seniors and Medicare eligibles. Drug price transparency is crucial in informing consumers and developing new strategies that address the issue of rising drug costs.

How is CMS involved?

Earlier this month, CMS proposed a new drug price transparency rule that was targeted at direct-to-consumer television advertising. This rule would require drug manufacturers to publish wholesale prices during commercials. This will allow beneficiaries to make informed drug purchasing decisions, especially beneficiaries with high deductibles and drug costs.

Direct-to-consumer television advertising can dramatically impact a beneficiary’s purchasing decisions. These commercials can spark informational discussions between beneficiaries and their health care providers, but understanding the costs is crucial when making a final decision.

State vs Federal Legislation

Several states across the US are implementing new bills and laws that require drug companies to not only report but also justify any dramatic increases in their drug prices. Since early August, there have been over 100 bills introduced into legislation addressing the different issues of drug price increases. 30 states have drafted a total of 60 drug price transparency bills.

States are feeling the pressure to improve the sustainability of their budget and promote coverage access to all of their residents. As the push for drug price transparency rises, more states may begin to explore new laws and federal legislation could be impacted. Many of these proposed changes are in the works and may be finalized in the near future.

How should you choose a pharmacy, doctor, or Part D plan?

Do you already have a primary pharmacy? Are you concerned about enrolling in a plan where your doctor is out of network?  Our agents at Medicare Plan Finder work with nearly every carrier in your state. Agents can help you enroll in the plan that best fits your needs, budget, and network requirements. Ready to learn more? Call us at 844-431-1832 or fill out this form to arrange a no-cost, no-obligation appointment with a top agent.

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