Payer, provider, pharma experts see few easy solutions to taming drug costs

From left, Joanne Kenen, Politico's executive editor for healthcare; Peter Bach, MD, director of health policy and outcomes for Memorial Sloan Kettering Cancer Center; Jenny Bryant, PhRMA's senior vice president of policy and research; Ceci Connolly, president and CEO of the Alliance of Community Health Plans; and Chip Davis, president and CEO of the Generic Pharmaceutical Association, speak at Tuesday's panel discussion at the Mayflower Hotel in the District of Columbia.

During a panel discussion Tuesday on the future of prescription drug costs, speakers were split on solutions to the problem of rising prices, whether the issue is likely to fade from the spotlight amid new political leadership, and even the magnitude of the problem itself.

Though she doesn’t see the issue going off the table entirely once Donald Trump is in the White House, Alliance of Community Health Plans (ACHP) President and CEO Ceci Connolly isn’t optimistic that his administration will make it a priority given all of the other pressing issues facing the president-elect.

“I suspect the issue of high drug prices is clinging to the edge of the table in Washington,” she said at a Politico Pro healthcare briefing at the Mayflower Hotel in the District of Columbia.

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But Rep. Jan Schakowsky, D-Ill., doesn’t see it that way, given what she sees as sustained public outrage about high-cost drugs. “There is a deep perception that people are getting gouged,” she said, adding that she and fellow Democrats plan to hold Trump accountable to address the issue, including his support of allowing Medicare to negotiate drug prices.

Particularly concerning to Schakowsky are prices hikes for drugs that have been on the market for decades rather than just the new, innovative specialty drugs that garner headlines, such as hepatitis C drug Sovaldi.

But Jenny Bryant, senior vice president of policy and research for PhRMA, challenged the “misleading” notion that prices are spiraling out of control, saying that headline-grabbing drug sticker prices do not accurately reflect what patients pay. Not only do pharmacy benefit managers engage in fierce negotiation over prices every day, she added, but health plans also “determine in a really aggressive way whether patients can access new drugs that come to market.” 

In fact, Bryant said there's considerable agreement among health plans and manufacturers on the desire to work together to create value-based payment frameworks for drugs, though she noted these efforts are sometimes hampered by regulatory barriers.

For Chip Davis, the president and CEO of the Generic Pharmaceutical Association, “to think that any policy position can be painted with a broad brush to solve what is perceived to be cost issues in the system is a really dangerous precedent.”

Addressing the generic-drug approval backlog at the FDA in order to get more drugs to market is one solution, but it isn’t the only answer, he said. After those drugs get FDA approval, there also must be a marketplace “that supports the uptake and the acceptance of generics,” he said.

Connolly agreed that solutions such as increased competition and value-based frameworks are important, but cautioned against losing sight of the fact that drug-price trends remain "exorbitant" and "unsustainable."

From a provider’s perspective, transparency is crucial to tackling the drug-price issue, said Peter Bach, M.D., the director of health policy and outcomes for Memorial Sloan Kettering Cancer Center, noting that patients and doctors need tools available at the point of care to indicate how much they will pay for medications. That’s especially critical if patients have more “skin in the game” due to increased cost-sharing levers.

One way that ACHP’s nonprofit member plans are trying to boost transparency is by offering drug-cost estimators on their websites, according to Connolly, but she noted it’s not always easy to maintain accurate information “when a drug can change its price whenever it darn well pleases.”

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