Oz Hints at Impending CMS Rule to Force Drug Price Transparency

The Trump administration hopes to issue a rule this year empowering regulators to “very forcefully” go after companies that don’t share information on drug costs, the CMS administrator said Tuesday.

The CMS could issue a rule this year requiring healthcare companies to share more information on drug costs, as the Trump administration continues to push for more price transparency in the sector, Administrator Dr. Mehmet Oz said Tuesday.

“If we can do this in an effective way — and we’ll have a rule on this by the end of the year, we hope — then we’ll be able to very forcefully go after folks who are not transparently sharing what it actually costs, or what the transaction prices were, for the drugs that Americans are trying to pick up,” Oz said.
Oz, who spoke during an event hosted by Transparency Rx, a group of small pharmacy benefit managers that say they’re more transparent on pricing than current market leaders, did not provide additional detail on the rule. The CMS did not respond to a request for more information.

But the administrator’s comments suggest the CMS could be considering rulemaking to force insurers and their pharmacy benefit managers, powerful middlemen in the pharmaceutical supply chain, to disclose the net prices of drugs, according to one expert.

“It’s entirely possible that [regulators in the Trump administration] continue to want disclosure of net prices,” said Matt Fiedler, a senior fellow at the Brookings Institution’s Center on Health Policy.

The cost of a drug after PBMs negotiate savings with drugmakers is a closely guarded secret for the companies. A lawsuit from the biggest PBM lobby, the PCMA, scuttled a previous attempt from the first Trump administration to require public disclosure of net costs.

But the HHS and other departments are currently hustling to improve healthcare price transparency following an executive order from President Donald Trump earlier this year. Now could be an opportunity to try again — and potentially put harsher enforcement penalties in place, too, amid low compliance among hospitals and payers with existing price transparency standards.

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