Advocacy & Practice Updates — Advocacy & Practice

ASRS Guiding Principles for Drug Policy

  • Preserve patient access. Savings from a model or negotiation should not be derived from reduced access. This has the potential to harm patients. Physicians must maintain just-in-time access to necessary drugs.
  • Preserve physician and patient choice of therapy. Physicians must continue to use their clinical judgement, in consultation with their patients, to provide the most appropriate treatment based on the unique characteristics of the patient’s disease.
  • Prevent penalties for physicians. Physicians do not set the drug prices. Any model or negotiation should be between the payers and the manufacturers. Manufacturers should bear the cost of penalties when they violate the terms of the model, negotiation, or price controls.
  • Protect physician practice finances. Programs should ensure predictable revenue streams for physicians so they can obtain the drugs and maintain the operations of the practice. Physicians should not be reimbursed at a level below the cost to obtain the drug. Hardship provisions should reimburse physicians for lost revenue in real time.
  • Improve transparency related to intermediaries in the supply chain. Established or proposed actors in the Part B drug supply chain, such as, pharmacy benefit managers (PBMs), specialty pharmacies, and competitive acquisition program (CAP) vendors operate with little transparency or oversight. While it can be difficult to obtain information on their practices, studies show that intermediaries such as PBMs impose fees on insurers while at the same time negotiate rebates with manufactures that they keep. This practice adds additional costs to the system without an increase in value. These intermediaries must have additional oversight so patients are not burdened by unnecessary out-of-pocket costs or delays in treatment. In addition, they should not contribute to additional administrative costs for practices.
  • Protect research toward new cures and treatments. Drug pricing policy should not negatively impact ongoing or future research and development of new treatments. Manufacturers should be able to earn a reasonable profit to continue research efforts.
  • Test models on a limited and voluntary scale before implementing mandatory, nationwide models.
  • Keep savings for drug pricing within healthcare. Savings derived from drug pricing legislation or demonstration models should be used for other healthcare purposes or preventing further cuts to Medicare.

(May 3, 2021)