Sen. Bill Cassidy (R.-La.) released a white paper outlining ideas to lower healthcare costs, including drug costs.
To promote transparency, Cassidy suggested giving patients rebates at the point of sale, prohibiting "gag clauses" that bar pharmacists from informing patients that their insurance co-pay for a drug could be more than the out-of-pocket cost.
He wrote that Medicare should not pay more than the cost of the lowest-priced drug within a drug class, and that U.S. prices for new drugs should be tied to prices in countries with similar economies.
The lawmaker recommended incentives to develop innovative therapies as opposed to "me-too" drugs, and preventing anticompetitive practices such as "evergreening" -- making minor changes to a drug to obtain a new patent near the end of its exclusivity -- and use of the REMS process to limit generic manufacturers' ability to access drug samples. He also recommended alternative payment models such as value-based purchasing, in which a drug's cost is rebated if therapy fails, and providing "unlimited use of a medicine for a set payment" in defined patient populations.
The white paper also suggested allowing states to combine the Medicaid and individual marketplace risk pools to reduce health insurance costs, and conducting studies on healthcare provider and insurance monopolies and on social determinants leading to health disparities.