CMS Issues Drug Pricing Transparency Proposed Rule

On Oct. 15, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Federal Health Insurance Programs for the Aged and Disabled by amending the Medicare Parts A, B, C, and D programs, as well as the Medicaid program, to require direct-to-consumer (DTC) television advertisements of prescription drugs and biological products for which payment is available through or under Medicare or Medicaid to include the Wholesale Acquisition Cost (WAC, or “list price”) of that drug or biological product.

According to a CMS statement, under the proposed rule, the price required to be posted would be for a typical course of treatment for an acute medication like an antibiotic, or a 30-day supply of medication for a chronic condition that is taken every month. The posting would take the form of a legible textual statement at the end of the ad, the agency said. The HHS Secretary would maintain a public list of drugs that were advertised in violation of this rule. CMS would provide an exception to the requirement to post prices for prescription drugs with list prices of less than $35 per month.

Read the proposed rule here.

CMS will accept comments on the proposed rule until Dec. 17, 2018.

ACCC policy staff is currently analyzing the proposed rule.

Posted 10/15/18