WASHINGTON, DC (April 24, 2018): The Council for Affordable Health Coverage (CAHC) – a coalition of employers, insurers, life science companies, PBMs, brokers, agents, patient groups, and physician organizations – sent a letter to President Trump today in anticipation of his upcoming remarks on prescription drug prices.
The letter calls upon the president to include “commonsense reforms to federal rules preventing the use of value-based payment arrangements in federal programs as part of any administration-led drug affordability initiative.”
Specifically, CAHC urges the president in its correspondence to:
- Allow team-based care and payment: CAHC notes that “Federal law prevents insurers, biopharmaceutical manufacturers, doctors and patients from coordinating care,” and urges the administration to “create a safe harbor from the Anti-kickback statute (AKS) to allow these team-based models in Medicare and Medicaid.”
- Use the latest technology to make value-based arrangements more fruitful: The letter explains that a safe harbor from the AKS should also “allow manufacturers and payers to share or donate technology (both hardware and software) that is necessary to monitor, track patient progress and automatically report outcomes to facilitate payment.”
- Support adherence to medications: In its correspondence, CAHC explains that “the administration should further establish a safe harbor to the AKS that allows biopharmaceutical manufacturers, payers, and others to provide physicians and patients with support programs designed to improve medication adherence.”
- Encourage deep price discounts: CAHC calls upon Congress to reform the outdated Medicaid “best price” program that creates a floor on discounts, noting that “Under best price, any discount that exceeds a statutory limit triggers rebate liability for manufacturers. Creating an exemption to best price for value-based arrangements would create powerful incentives to lower prices in value based arrangements or even offer money back guarantees for products that don’t work for patients.”
CAHC’s letter to President Trump follows the May 2017 release of its Prescriptions for Affordability blueprint – a set of prescription drug cost solutions developed by a cross-industry working group of stakeholders including patients, consumers, employers, payers, PBMs, biopharmaceutical manufacturers, and others – which largely focused on removing regulatory barriers to VBAs and is estimated to save up to $71 billion per year.
The Council for Affordable Health Coverage (CAHC) is a broad-based alliance with a primary focus: bringing down the cost of health care for all Americans. CAHC promotes policies that lower health costs through increased competition, informed consumers and more choices to help promote access to affordable coverage. Learn more at CAHC.net.