Trump administration tackles drug advertising

Coming this summer: another addition to the “fine print” on all those drug commercials. Under a new rule announced this month by the Trump administration, pharmaceutical companies will have to reveal how much their drug costs during TV commercials.

The rule is set to go into effect this summer and will require drug companies to include the price of a drug if it exceeds $35 for a 30-day supply, or the usual course of therapy.

The move is meant to increase transparency in the industry and ideally force pharmaceutical companies to lower its sticker prices on drugs for fear of appearing too expensive.

“Requiring the inclusion of drug list prices in TV ads is the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the healthcare they receive,” said Alex Azar, Health and Human Services secretary.

As expected, drug companies pushed back on the new rule. Representatives said they fear including drug prices during commercials will discourage customers from asking their physicians about the drug because they believe they cannot afford it. The new rule stipulates listing the price before any discounts or health insurance coverage, which could lower the cost.

It is notable, however, that because of rising costs an increasing number of Americans are being forced onto high deductible health plans, which can often lack the comprehensive drug coverage required to significantly reduce the cost of prescriptions.

“If drug companies are ashamed of those prices—lower them,” President Donald Trump tweeted shortly after the rule was announced.

Industry experts do not necessarily oppose the new rule, but are skeptical it will result in substantial cost reductions, especially because enforcement of the law is left to the drug companies themselves.

If one drug company fails to include the pricing information in an ad, a competitor can file a lawsuit under the deceptive and unfair trade practice provisions of the Lanham Act. No additional oversight plan has been announced by the Trump administration.

The consensus among Americans appears to be that added transparency in the pharmaceutical industry may be helpful, but is no guarantee. According to a POLITICO/Harvard poll in the summer last year, 63 percent of Americans favored including price information in drug advertisements, but only 28 percent believed it would lower costs.

As for the ClaimLinx team, we don’t expect this to bring about big change in the industry. If it does, though, you can bet we will be ready to use it to our advantage to lower costs for members and clients.

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Improve your health with Spring cleaning

Jumping into Spring with a good cleaning means participating in an age-old tradition rooted in biological, cultural and even practical traditions that goes back hundreds of years.

The change of season has long required a good scrubbing because of the byproducts of keeping a home warm. Think of the 1800s and earlier, when homes were coated with a noticeable layer of soot from the fires lit with coal and wood or the lamps burning oil and kerosene.

Spring also coincides with religious ceremonies associated with a tradition of cleaning the home or altar, including Passover, Easter and Nowruz, or Persian New Year.

Spring cleaning isn’t just practical or a tradition, though. Studies have found cleaning, as an activity, can help reduce stress, and the resulting lack of clutter and cleanliness curtails anxiety. It also helps improve health by improving the air quality and helping you remain active without thinking about it.

Here are 7 tips to get you started Spring cleaning:

  1. Set a schedule: It’s always better to have goals and structure when starting a big house project. Make a schedule that fits your availability, such as setting particular days or weeks to de-clutter, clean the kitchen, garage, living spaces, bathrooms, bedrooms and more.
  2. Top to bottom: Start your cleaning with the ceiling and work your way down. That way you avoid having to repeat dusting or vacuuming along the way.
  3. Tidy up: Clutter creates stress in your environment, so it’s important to start any Spring cleaning with a cleanse. Use some quick questions to ask yourself to help you decide if an item is worth keeping. “Have I used this in the last year? Does this item spark joy in my life?” Read Marie Kondo’s book The Life-Changing Magic of Tidying Up for more on how to get rid of old items and organize.
  4. Enlist help: You and your family helped make the mess together, it’s only right that you clean it together. Simple tasks can be allocated to young children and this is a good opportunity to teach older children how to do more thorough cleaning. They may not enjoy the process but they will certainly love a clean home.
  5. Deep Clean: Don’t forget all the items you don’t clean on a regular basis, such as curtains, ceiling fans, blinds, rugs, carpets and anything else. Cleaning these items even a few times per year will help them last longer and cut down on the allergens and germs in your house.
  6. Stay safe: Be careful with the chemicals you’re using to clean. Regular household cleaners can be dangerous when mixed together or if used without proper ventilation. So use green or natural chemicals when you can. They’re less harsh on the environment and on your belongings.

These are just a few tips to get you started. See more tips about cleaning individuals items by clicking here.

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Senate digs into why drug prices are so high

Executives from pharmaceutical companies and pharmacy benefit managers could not agree on the main factors causing rising drug costs as they appeared before the Senate Finance Committee in a series of hearings aimed at investigating the industry and finding possible solutions.

Each set of industry leaders were pointing the finger at each other for the cause. Neither of them was in favor of sharing more information with the American public as a means of decreasing costs, though both were in favor of the other having to do so.

The hearings began on February 26 with seven executives from the top drugmakers in the country. All of the Senators, Republican and Democrat, expressed deep concern for the rising cost of drugs, especially when considering the price difference for the same products in Europe and other countries.

“You’re willing to sit by and hose the American consumer while giving price breaks to consumers overseas,” said Senator Ron Wyden of Oregon, the senior Democrat on the committee.

Drug company executives did not have many answers for this. They said Americans receive drugs earlier than those in other countries and said they feel obligated to sell their products abroad, despite their lower profitability because it would be “immoral to leave the patients behind,” said Kenneth C. Frazier, the chief executive of Merck.

They said the main issue concerning drug pricing is not the high list prices, but that much of the rebates their companies offer never reach patients. They claim they are swallowed by the middlemen in the industry, the pharmacy benefit managers (PBM). They were in favor of more transparency regarding rebates and the Trump administration’s proposal to get rid of rebates.

But Senators were not so convinced this would solve the problem. They wanted firmer, more concrete commitments from the drugmakers that should Congress abolish rebates, drugmakers would lower their list prices.

On Tuesday, Senators had a hearing with executives from the top PBMs in the country. Many Senators were puzzled at their role in the overall drug market other than as “middlemen” taking a cut of profits along the way. Traditionally they are the go-betweens that negotiate with drugmakers on which medicines are covered and by how much on an insurance plan.

PBM executives balked at the suggestion they exist simply to increase costs. They said they are an important part of the system, as experts in pharmaceuticals, aimed at finding for its clients the cheapest, most effective drugs to cover.

They blamed rising prices on a lack of competition in the industry. They said having more generic or biosimilar drugs available would help with negotiations. It’s a solution that would affect their favorite foe, the drug manufacturers the most.

It remains to be seen if these hearings will result in any additional legislation. The Trump administration has proposed plans intended to curb rising costs, but there remains a lot of debate in Congress if the proposed measures would accomplish its goal. Both parties are eager to make progress on this issue, as rising healthcare costs are one of the biggest problems facing most Americans.

President Trump highlights healthcare in State of the Union

Health care has long been a priority for the Trump administration, and the President used his State of the Union speech this week to highlight his priorities when it comes to improving health and bringing down costs for consumers.

Ahead of the speech, the Trump administration released its plan to curb drug prices for Americans, especially those under 65. His plan proposes eliminating the legal protections that allow pharmacy benefit managers to accept rebates from drug companies for brand-name drugs. Rebates would instead be credited to patients when they fill their prescriptions at the pharmacy.

These after-the-fact discounts are seen by many as one of the driving factors pushing up the list price of drugs. President Trump focused on the struggle this can cause, as many Americans are increasingly responsible for paying larger portions of these prices.

He also called for more transparency in general in the healthcare industry, asserting that if  hospitals, drug companies and insurers had to “disclose real prices,” consumers would have more information that would foster more competition.

“It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, this is unfair, and together we will stop it. We will stop it fast. I am asking the Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients.”

There is bipartisan support in Congress for legislation to bring down drug prices and to improve healthcare pricing overall, but any bill would likely face strong opposition from lobbyists from pharmacy benefit managers, pharmaceutical companies and insurers.

Complicating the issue as well is the current climate in Washington with the divided government. It is still unclear if Congress will be able to work with the President on key issues like these, while so much time and energy is being spent on other subjects, like border security and the government budget.

President Trump went on to talk about his hopes for increased funding for research on treatments for childhood cancer and a cure for HIV and AIDS in the United States within the next 10 years. He called on Democrats and Republicans to pass his budget, which seeks additional funding for the National Institute of Health for both initiatives.

Both priorities are largely seen as an outreach to Democrats and as issues the country could unify around. No specific legislation outside of the budget proposals have been released.

Overall, President Trump’s State of the Union address covered a wide range of topics but his focus on these initiatives shows healthcare remains a priority for the administration.

It will be a game of watch-and-see as Trump’s own campaign for reelection becomes increasingly underway. He may want to tout a big legislative win regarding healthcare on the campaign trail, especially as efforts to “repeal and replace” the Affordable Care Act were unsuccessful early in his presidency.