As drug makers lobby policymakers with advertorials, Trump plan to cut drug prices is short on details

Trudy Lieberman

Veteran health journalist and columnist Trudy Lieberman is back with another "Thinking About Health" column for the Rural Health News Service after enduring her own health crisis that kept her from writing for four months. In her latest column, she ponders the Trump administration's plan for dealing with America's high drug prices. The pharmaceutical industry is reportedly relieved at the proposal, which a Wall Street Journal story described as falling short of "more far-reaching ideas."

"The plan continued the current system under which the government does not negotiate the prices it pays for medicines under the Medicare program, a far-reaching solution that I’ve discussed before in this space," Lieberman writes. "The 2003 law that gave seniors a drug benefit under Medicare prohibited such negotiations, which pharmaceutical manufacturers loudly and forcefully opposed. They feared that allowing the government to use its muscle to bargain over drug prices might slow their escalating increases."

Drug prices didn't increase much for a few years after the 2003 law was passed, but that has changed dramatically in the past few years: one diabetic told Lieberman that the price of an insulin pen increased from $73 in 2014 to $123 in March 2018, though insulin is a well-established drug.

"The pricing practices of all the players in the drug distribution system are responsible for the confusing pricing system we have," Lieberman writes. "Pharmaceutical manufacturers and pharmacy benefit managers – third-party administrators brought in to help insurers manage their drug costs – bear responsibility. So do the pharmacies themselves, when they offer coupons to consumers to lower their out-of-pocket costs, easing some individual burdens but doing nothing to solve the larger problem."

Lieberman says Trump's plan is short on details and doubts it will bring greater clarity or lower prices to consumers. She notes that the pharmaceutical industry has been lobbying hard to revamp its image and cast doubt on its role in ballooning health care costs. 

"Almost daily, a drug company or a related business sponsored content in several online health newsletters that are read by Washington lobbyists, health experts, congressional staff members, and journalists," Lieberman writes. "Sometimes the sponsored messages looked like the regular content of the newsletter. Even though they were flagged as paid content, the format often made me think I was reading a legitimate news story. One 'story' sponsored by the pharmacy benefit management industry said they were not the ones to blame for higher prices. With clout like this, is it any wonder the industry has managed to keep drug price negotiation out of the picture?"

This should serve as a warning to newspapers that sometimes fill their news hole with advertorial or "sponsored content," or those that allow "native advertising," essentially the digital version of editorial. "Such messages should be clearly and prominently identified as sponsored," said Al Cross, director of the Institute for Rural Journalism and Community Issues, publisher of The Rural Blog. "Readers always deserve to know who is producing all the material they are reading."