Inserting Transparency in Drug Pricing
Category: ACA and Policy, Cost of Healthcare, Health Insurance

Drug Company Magic, Part 2

Drug Company Magic, Part 2

As we move further into 2017, I am increasingly concerned about the impact drug price increases have on your premiums. I’ve written before about the “magical” way drug companies arrive at their pricing.

To make matters worse, it’s very difficult for all of us as patients to make informed decisions about which drugs we take for our health conditions. It’s even hard for my doctors to find out the price of the drugs they prescribe. Almost every condition we get treated for has multiple drug options that medical professionals can prescribe for us, and often the different drugs are quite similar in their composition and effect on the condition. In this situation, more information is better.

Wouldn’t it be nice if your doctor had some simple data about the drug he or she prescribes BEFORE choosing it for you? Such as the PRICE of the drug?

We work through our in-house experts constantly to bring you as much transparency as possible to the way drugs are prescribed and priced – and how these prices could affect your insurance premium. I’d like to say that the manufacturers and distributors of these important medicines were cooperative in that effort, to help to make us all smart consumers. But that would be a lie.

Changes Coming for Louisiana?
Two important but relatively simple bills are winding their way through the Louisiana Legislature as I’m writing this. They are Senate Bill 59 and House Bill 436. Similar bills have been proposed in recent years here in Louisiana, and all have been effectively killed by drug-company lobbying power. But here we are, trying one more time to get your doctor and you important and simple information about the medicines he or she prescribes. The battle goes on.

The Senate Bill (SB-59) has one basic request:

This law would require pharmaceutical drug marketers to present a completed form disclosing current and historical drug pricing information when they are marketing the drug to a prescriber or the prescriber’s staff.

Complementing Senate Bill 59, House Bill 436 has two major components:

  • To create a committee that would develop a “critical prescription drug list” and collect information about the drugs on that list to include in a publicly available annual report.

The annual report would describe prescription drug prices and their role in overall healthcare spending in Louisiana; and

  • To require pharmaceutical drug marketers to present a completed form disclosing current and historical drug pricing information.

Seems simple enough. Just the fact that we need actual legislation to get this information should tell you all you need to know about what’s wrong with drug pricing here in Louisiana.

What These Bills Would Do If They Become Law

So, what are we really asking for here? We simply want your doctor to know how much a drug costs before he prescribes it to you. We want the drug companies to be required to tell your doctor how much a drug costs at the same time they are telling him how wonderful it is. We want your doctor and his staff to be able to at least tell you when one drug’s base price is more or less expensive than another. Just because our health plan protects you from this price at the pharmacy, doesn’t mean that it won’t affect your health plan premium prices later.

Is that too much to ask?

“Did you know the same drug you are taking now here in the U.S. is often much cheaper in Canada?”

According to the drug manufacturers, it is. They are pouring lobbyists and money into the battle to kill both of these bills, because the last thing they want you or your doctor to know is how much they are charging for their medicines. They don’t want you and, particularly, your doctor to know how much they are driving up your insurance premiums.

Doctors are expected to recommend drugs to treat a health problem, yet they are kept generally in the dark about how much those drugs cost. These bills shine a light on each drug’s baseline price by making it conveniently accessible to doctors.

Here at Straight Talk, we have spoken often about the importance of transparency in helping people lead healthier, happier lives. We want your doctor to have this information when prescribing the drug that treats your condition so they can see the complete picture of the drug, its safety, how well it works and its basic cost. Your doctor deserves to have this data when helping you make decisions about your care. This tiny bit of light we are trying to shine right now is a start.

Did you know the same drug you are taking now here in the U.S. is often much cheaper in Canada? One reason is that Canada has a multi-state commission that scans drug prices and sets them for their citizens at prices they consider reasonable. These prices are readily available at any pharmacy before you select or purchase any medicines. Overall, their process is much more transparent and reasonable than ours and their drugs are much, much cheaper. Information is power.

Finally, I want to make sure you all know that in 2004, when I began working here at Blue Cross and Blue Shield of Louisiana, 12% of your premiums paid for everyone’s medicines.

In 2016, that number has soared to 26% of your premiums, and it is still rising.

We owe it to you to support any effort to get your doctor (and therefore, you) the best, straightest data on drug pricing that he or she can get. These two bills represent Step 1 in that process. We all need to contact our state legislators and hold them accountable to you and me, not to the drug companies, on this issue.

How You Can Get Involved

If you care about this issue, there are a few things you can do:

  • Contact your representative and/or senator.
  • Attend a committee hearing and sign a card indicating your support for this legislation. You can also watch many committee hearings live on
  • Meet with bill sponsors or testify for legislation.

If you’d like to contact your representative or senator, fill out your information here to find your Louisiana Legislators.

Only together can we defeat the forces that don’t want you or your doctor to know how much your medicines cost.

I’m already out there! Feel free to join me.


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