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Medicare Proposes Regulation for Disclosure of Drug Prices

CMS proposes to require manufacturers to disclose drug prices in television ads.  They said the proposed regulation would lower prescription drug prices by requiring companies to list prices for prescription drugs covered by Medicare or Medicaid. 

Recently, the Centers for Medicare & Medicaid Services proposed a requirement that prescription drug manufacturers post the Wholesale Acquisition Cost (WAC) for drugs covered in Medicare or Medicaid in direct-to-consumer television advertisements.

“This historic proposal is an important way to create new incentives for drug companies to start lowering their list prices, rather than raising them,” said HHS Secretary Alex Azar. “President Trump’s drug-pricing blueprint called for HHS to consider how to accomplish this goal, and now we are following through on this measure to better inform patients, help them lower their drug costs, and reduce unreasonable spending in Medicare and Medicaid.”

CMS Administrator Seema Verma also said, “We are committed to price transparency across-the-board, and prescription drugs are no different.  Patients often pay their cost-sharing or deductible off of a drug’s list price.  Today’s proposed rule would ensure that those list prices are included in television advertisements, so patients have the information they need to make informed decisions.”

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 thirty-day supply of medication for a chronic condition that is taken every month.  The posting would take the form of a legible statement at the end of the ad.  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.

For more about the proposed rule, please download the Federal Register >>

To learn more about how our Medicare Lien and Set Aside practices are achieving significant savings for our clients, contact Robert J. Blackburn at This email address is being protected from spambots. You need JavaScript enabled to view it. or 585-586-4530.

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By Robert J. Blackburn, Managing Principal, Blackburn Group, Inc., contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..

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