PhRMA Ad Misleads on Medicare Drug Negotiation Legislation
In TV ads, the pharmaceutical industry claims congressional plans to allow the federal government to negotiate drug prices in Medicare would deny beneficiaries’ access to medicines their doctors prescribe. Experts say that’s unlikely, and an inaccurate portrayal of recent legislation.
Under current law, the federal government is barred from negotiating prices with drug manufacturers for Medicare. Instead, the prescription drug program, called Part D, consists of many privately run plans that conduct their own negotiations and each set their own formulary, or list of drugs they cover — though they are required by Medicare to cover many medications.
The relevant provision of the law is called the noninterference clause. It says the secretary of the Department of Health and Human Services “may not interfere with the negotiations between drug manufacturers and pharmacies and PDP [prescription drug plan] sponsors” and “may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs.”
Many politicians say it’s long past time to create an exception to that clause, allowing the secretary to negotiate prices for some drugs, in order to lower the high cost of medicines in the U.S. and save both the government and seniors money.
Estimates vary on how much more U.S. consumers pay for prescription drugs than many other countries. When , one expert told us on average brand-name drugs were about 10% to 40% more in the
