Editor’s Desk

CMS negotiation top pick for curbing high drug prices

Peter Wehrwein

Allowing CMS to negotiate drug prices was the top pick of Managed Care readers and other health care executives as a way to curb high drug costs, according to a MediMedia Research survey.

But that pick doesn’t come with much optimism that CMS negotiation—or, for that matter, other efforts to rein in drug prices—can do much about the problem.   

“There is low expectation that any actions will be successful in curbing drug prices any time soon,” notes Earlene Biggs, head of MediMedia Research, a division of MediMedia Managed Markets. 

Managed Care is owned by MediMedia Managed Markets, a division of Icon plc.

CMS negotiation was the top pick of 26% of the 432 respondents to the online survey, which was conducted in March and April.  A ban or limitation on direct-to-consumer advertising came in second and was the top pick of 16% of the respondents.

Top pick for curbing high drug prices

But when the survey asked about the likelihood of these and other actions to curb drug prices happening, it didn’t find much optimism. Only 19% thought it was highly likely that CMS would be allowed to negotiate drugs and a slightly larger proportion—23%—rated the possibility as unlikely.

The differential was even greater for a ban or limitations on direct-to-consumer advertising. Only 4% thought that they were likely to happen and more than half (51%) deemed them unlikely.

Likelihood that it will happen

It’s not much consolation, but there’s wide agreement that high drug prices are a serious problem. Almost two thirds (63%) of the survey respondents rated the seriousness of high prices for medication as high relative to other health care problems whereas only a small fraction (4%) rated high prices as not serious.

Seriousness of high prices for medication

Rated on a 1 to 10 scale. 1 = Not serious at all. 10 = extremely serious.

But seriousness also seemed to be coupled with a perception of intractability.  When asked a general question about efforts to curb prices, only 6% rated the chances of success as high and 30% rated them as low.

The Medimedia Research survey also asked Managed Care readers and other health care executives their opinion about the root causes of high prices. A solid majority (61%) picked market distortions that create monopolies as a root cause and more than half (53%) identified inflated demand from direct-to-consumer advertising.

A sizable proportion of the respondents selected causes that the pharmaceutical industry talks about, including the high cost of drug development that needs to be recouped for investment in drug development to continue (50%) and regulations imposed by the FDA and other entities (32%).

Root causes of high drug prices in the U.S.

Biggs points out government action of some kind was favored by many respondents. The results show that 59% had a ban or limitations on direct-to-consumer advertising among their top five picks, and 56% included allowing CMS to negotiate prices. Close on their heels were mandating more transparency about PBM discounts and rebates (46%) and the federal government capping prices based on value (41%). However, a sizable minority (38%) favored less regulation to encourage more competition.

Respondents that had this item in their top 5 actions to curb drug prices