In the immediate aftermath of President Donald Trump's big drug pricing speech, industry watchers noted a relatively unique proposal: forcing drugmakers to slap sticker prices into consumer advertising. Now, five senators are taking the next step.
It's a small one, granted. They're asking top drugmakers to voluntarily add pricing information in their TV commercials and print ads. In letters to executives at Pfizer, AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Merck & Co., GlaxoSmithKline and Novartis, five Democratic and independent senators asked the drugmakers to immediately add drug prices to their direct-to-consumer promos.
And that's a lot of ads, as the letter noted. Each of the drugmakers spend more than $100 million on advertising every year.
Representatives for most of the companies didn't immediately respond to a request for comment. Novartis and Pfizer received the letters, the companies confirmed.
GSK believes there "continues to be a role for direct-to-consumer advertising in providing scientifically accurate information about prescription medicines to patients so they are better informed about their health care," a spokeswoman said. The company is evaluating the details of the proposed legislation.
Out of pocket costs vary significantly for patients, she added, so the company regularly shares info about "what coverage the healthcare provider should expect for their patients, based on the provider’s location and their patients’ demographics."
As the lawmakers point out, the American Medical Association previously determined that DTC ads boost demand "for new and more expensive drugs, even when these drugs may not be appropriate.” Sen. Dick Durbin, D-Ill., who previously introduced legislation requiring pricing in ads, wrote the letters. Sens. Kirsten Gillibrand, D-N.Y.; Maggie Hassan, D-N.H.; Sherrod Brown, D-Ohio; and Angus King, I-Maine, signed on.
Sen. Durbin introduced the Drug-Price Transparency in Communications Act in November; the bill is currently in the Senate Committee on Health, Education, Labor, and Pensions, according to an online summary.
The fact that Democratic senators and the Trump administration are on board with the proposal suggests it could gain steam as a bipartisan measure to attempt to rein in costs and increase transparency. DTC advertising is illegal in most of the world, with New Zealand the only other developed country that allows it.
There are potential obstacles. FDA Commissioner Scott Gottlieb recently said his agency is looking at Trump's proposal, made on May 11 and backed since by HHS Secretary Alex Azar. But the requirement could be unconstitutional "compelled speech," according to previous remarks from Gottlieb covered by FierceHealthcare.
Aside from that potential stumbling block, many industry watchers have pointed out that drug pricing is complex and opaque; they've questioned which prices would end up in the ads. Sen. Durbin's legislation suggests list prices—those before rebates and discounts—be included, according to Friday's press release.
A PhRMA spokesperson said list prices disclosures in DTC ads "would provide no meaningful benefit to patients given the significant negotiations occurring in the marketplace."
"Price comparison websites already exist to help consumers compare and look for the best retail prices, the price the consumer actually pays for their medicines at their pharmacy," PhRMA's statement said.
When the president unveiled his much-anticipated pricing plan, many experts said it includes some steps that could help rein in costs but spares the pharma industry from real reform. Some of the ideas, such as somehow pushing other countries to pay more to help fund U.S. innovation, stand to benefit the industry.
Aside from DTC price disclosures, the administration aims to spotlight drugmakers that abuse regulations to thwart generic competition, free Medicare to negotiate more prices, end pharmacist gag clauses and encourage drugmakers to be good citizens by lowering costs themselves. Further, after Trump's speech, Azar warned that drugmakers who unreasonably raise prices could anger the president.
Trump will be "very interested in the next company that takes a price increase not justified by inflation or change in clinical benefit," Azar said, adding, "I can tell you I wouldn’t have wanted to be the one to do that."
Editor's note: This story was updated with statements from GlaxoSmithKline and PhRMA.