More transparency for lower costs

September 19, 2018

We live in an age of information. We have access to more information than at any other time in history. With a touch on your phone or click of a mouse, a search for an answer to any question will be met with millions of results. This information has great value, sometimes more than we realize. Information has the power to improve lives and save them.

But when Nebraska families make critical decisions on medical treatments, access to information on cost disappears. Patients who seek procedures or medication often aren’t aware of the full cost when they agree to the treatment. This lack of transparency leaves families feeling like they have no control and are powerless to large hospitals and big insurance companies.

It’s common sense: if you are going to purchase something important, you should have an opportunity to look at the price tag first.

For example, when a young girl needs an MRI after she twists her knee playing soccer, she and her mother should be able to consider a variety of options. They should be able to “shop” for the time, price, and location that works best for them. They might find that they want to stay up late and drive further from home for a more affordable option. They should have the flexibility to schedule the appointment where and when they want, instead of being forced into a choice without knowing the cost.

Americans deserve simplicity and clarity in their health care choices. By increasing competition and transparency, we can address the skyrocketing costs that families have endured for far too long. With this in mind, I’m cosponsoring three bipartisan bills in the Senate that will help put Nebraskans back in control of their health care choices.

First, I supported the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act. It’s no secret that drug prices are quickly rising. Today, nearly one in four patients say they haven’t filled a prescription due to the excessive cost. Many Americans rely on generic medications that are more affordable. Some bad actors in the health care industry employ tactics to delay, or sometimes block, competing generic drugs from entering the market.

This solution would create a new civil action that generic developers could bring in federal court if brand-name companies fail to provide a generic developer with sufficient samples of a drug. The CREATES Act would also grant the Food and Drug Administration (FDA) more discretion to approve alternative safety protocols, rather than require parties to develop a shared safety protocol themselves.

Second, the Patient Right to Know Drug Prices Act would bar insurers or pharmacy benefit managers (PBMs) from using what’s known as “gag clauses.” These secret contracts prevent pharmacists from informing patients that they could pay less for a drug if they paid out-of-pocket, rather than through their insurance plan. Many stories have surfaced of customers paying more for medication under their insurance plan, when they would have owed only a fraction had they paid out-of-pocket. I was proud to vote in support of this bill as it passed the Senate.

Finally, the Know the Lowest Price Act goes further. The bill would also prevent insurers or PBMs from using these gag clauses. This would apply to entities offering prescription drug plans under Medicare Part D or Medicare Advantage. This bipartisan measure recently passed the Senate unanimously.

Without transparency, special interests can rig the system behind closed doors to get between you and your doctor. Families are simply paying too much for health care and prescription drugs, ultimately taking hard earned money out of Nebraskans’ pockets. I am committed to working with my colleagues across the aisle to provide much-needed relief to Nebraska families.

Thank you for participating in the democratic process. I look forward to visiting with you again next week.

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