On May 8, 2019, the Department of Health and Human Services (“HHS”) announced a final rule that will require direct-to-consumer television advertisements to include the list price for prescription pharmaceuticals that are covered by Medicare or Medicaid. The rule, which was promulgated through the Center for Medicare & Medicaid Services (“CMS”), requires the “the Wholesale Acquisition Cost” (i.e., the list price) of the drug to be included in the advertisement if the price is $35 or more for a one-month supply, or for the usual course of therapy.
“Patients have the right to know the prices of healthcare services, and CMS is serious about empowering patients with this information across-the-board,” said CMS Administrator Seema Verma.
This new CMS rule requires that advertisements for certain prescription drugs or biological products on television (including broadcast, cable, streaming and satellite) contain a “textual statement” indicating the Wholesale Acquisition Cost (referred to as “WAC” or the “list price”) for a “typical 30-day regimen or for a typical course of treatment, whichever is most appropriate, as determined on the first day of the quarter during which the advertisement is being aired or otherwise broadcast.” The statement is as follows: “The list price for a [30-day supply of] [typical course of treatment with] [name of prescription drug or biological product] is [insert list price]. If you have health insurance that covers drugs, your cost may be different.” It is important to note that the rule only applies to television advertisements, but not advertisements through other platforms, such as YouTube or Facebook.
Click here for a fact sheet about the final rule.