Insurers Drop Policy Brief On Drug Prices

Addresses Rising Drug Costs

Prescription drugs are helping people to live longer, enabling better treatment of illnesses and even saving lives. Those popular goals are often cited when the industry comes in for criticism, and a new brief from the insurance industry suggests it’s time for more oversight and regulation.

Ahead of a hearing Tuesday on cost control bills, the Massachusetts Association of Health Plans is pointing to health care costs that are exceeding the state’s benchmarks and singling out increases in the prescription and specialty drug prices as major drivers behind rising employer and consumer costs.

In a new policy brief, the insurance trade group lays out recommendations, most of which require state or federal action, to address drug costs.

Requiring transparency in prescription drug pricing is one idea, as well as requiring the drug sector to participate in annual cost trends hearings that draw an assortment of other major health care players. The policy brief urges expanding the Health Policy Commission’s drug pricing review authority, creation of penalties for excessive drug price increases, and a closer look at the medical efficacy of new treatments that weighs added benefits against additional costs.

“Drug spending is heavily driven by a relatively small number of high-cost drugs,” the brief says. “Nationally, the cost of specialty drugs has continued to grow, totaling $301 billion in 2021, an increase of 43 percent since 2016. Specialty drugs represented 50 percent of total drug spending in 2021. While 80 percent of prescription fills are for generic drugs, brand name drugs accounted for 80 percent of prescription drug spending, with little change over time.”