{"id":9740,"date":"2025-11-20T18:00:47","date_gmt":"2025-11-20T18:00:47","guid":{"rendered":"https:\/\/medical-article.com\/?p=9740"},"modified":"2025-11-20T18:00:47","modified_gmt":"2025-11-20T18:00:47","slug":"when-drug-price-transparency-isnt-enough","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=9740","title":{"rendered":"When Drug Price Transparency Isn\u2019t Enough"},"content":{"rendered":"<p>By KRISTINA SMITH &amp; PHIYEN NGUYEN<\/p>\n<div class=\"wp-block-image\">\n<\/div>\n<div class=\"wp-block-image\">\n<\/div>\n<p>Policymakers and advocates often promote drug price transparency to lower costs and improve equity. While transparency is an important first step toward accountability and informed public budgeting, it does<em> not<\/em> guarantee affordable prices or fair access to medicines.<\/p>\n<p><strong>Transparency Has Some Benefits<\/strong><\/p>\n<p><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5345916\/\">Drug price transparency<\/a> helps show how and why medicines cost what they do along the supply chain (i.e., from the manufacturer to the pharmacy), which makes it easier to identify where costs can be reduced or better regulated. By making this information public, transparency allows patients, payers, and policymakers to make more informed decisions and encourage manufacturers to prices drugs more fairly. Ultimately, it supports a fairer system where patients can better afford and obtain the treatments they need, improving access to care.<\/p>\n<p><strong>States with Drug Transparency Laws<\/strong><\/p>\n<p>While federal policy to improve price transparency is lacking, the states have moved to make things clearer for patients and payers. Vermont was the <a href=\"https:\/\/www.statnews.com\/pharmalot\/2016\/06\/06\/vermont-drug-prices-transparency\/\">first<\/a> U.S. state to enact a drug price transparency law in 2016. Since then, many others have followed suit. At least <a href=\"https:\/\/nashp.org\/state-tracker\/2025-state-legislation-to-lower-prescription-drug-costs\/\">14<\/a> states have passed some version of transparency legislation, though the details and their enforcement of these laws differ widely.<\/p>\n<p>For example, only Vermont and Maine <a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2751892\">require<\/a> drug companies or insurers to disclose the actual prices paid after discounts (called the \u201c<a href=\"https:\/\/dictionary.cambridge.org\/us\/dictionary\/english\/net-price\">net price<\/a>\u201d). Alternately, Oregon and Nevada <a href=\"https:\/\/nashp.org\/wp-content\/uploads\/2018\/06\/TransparencyChart_-6_29_2018.pdf\">require<\/a> drug manufacturers to publicly report their profit to state government agencies. And Connecticut, Louisiana, and Nevada <a href=\"https:\/\/www.ama-assn.org\/health-care-advocacy\/access-care\/what-are-pharmacy-benefit-managers-pbms-and-why-we-need-reform\">mandate<\/a> pharmacy benefit managers (PBMs) to <a href=\"https:\/\/www.cms.gov\/marketplace-private-insurance\/health-plans-issuers\/drug-data-pricing-rebate-review#:~:text=The%20Affordable%20Care%20Act%20added%20section%201150(a)(2),Department%20of%20Health%20and%20Human%20Services%20(HHS).\">report<\/a> the total rebates they receive, but not the amounts for each specific drug. Despite these efforts, <a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2751892\">no<\/a> state has yet achieved full transparency across the <em>entire <\/em>drug supply chain.<\/p>\n<p><strong>Transparency is Not Enough<\/strong><\/p>\n<p>Even with clear pricing, Americans still pay about <a href=\"https:\/\/www.rand.org\/pubs\/research_reports\/RR2956.html\">2.6 times<\/a> more for prescription drugs than people in other wealthy countries. Early <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36372608\/\">evidence<\/a> suggests that these laws have done<a href=\"https:\/\/www.statnews.com\/wp-content\/uploads\/2025\/06\/Rahim-Kesselheim-MQ-state-transparency-laws-1.pdf\"> little<\/a> to curb drug prices. To date, only four states \u2013 <a href=\"https:\/\/www.dmhc.ca.gov\/Portals\/0\/Docs\/DO\/SB172023Report.pdf\">California<\/a>, <a href=\"https:\/\/mhdo.maine.gov\/RxDrugPricingTransparency.htm\">Maine<\/a>, <a href=\"https:\/\/www.health.state.mn.us\/data\/rxtransparency\/docs\/rxlegrpt2024.pdf\">Minnesota<\/a>, and <a href=\"https:\/\/dfr.oregon.gov\/drugtransparency\/pages\/annual-reports.aspx\">Oregon<\/a> \u2013 have published analyses of their own laws. These reports share common <a href=\"https:\/\/nashp.org\/what-are-we-learning-from-state-reporting-on-drug-pricing\/\">concerns<\/a>: difficulty tracking pricing across the supply chain and uncertainty about whether state agencies have the authority (or the will) to act when data is incomplete or unreliable.\u00a0<\/p>\n<p>Most transparency laws fall short on requiring detailed cost or profit data, <a href=\"https:\/\/mostpolicyinitiative.org\/science-note\/drug-pricing-transparency\/#:~:text=Price-setting%20details%20(e.g.%2C,step%20in%20the%20supply%20chain.\">focusing<\/a> instead on broad price trends. As a result, this narrow scope makes it difficult to identify the exact drivers of high drug prices. Even when transparency discourages manufacturers from raising prices, these policies do not directly control pricing or define what constitutes an \u2018unjustified\u2019 price increase. Manufacturers can simply adjust by <a href=\"https:\/\/www.library.ca.gov\/wp-content\/uploads\/crb-reports\/Prescription_Drug_Pricing_and_Cost_Transparency_in_California-Oct_2022v3.pdf\">setting<\/a> higher launch prices or <a href=\"https:\/\/nashp.org\/drug-price-transparency-laws-position-states-to-impact-drug-prices\/\">implementing<\/a> smaller, more frequent increases to stay below reporting thresholds. Still, the result is a system where drug costs can <a href=\"https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=3364636#:~:text=Marketing%20practices%2C%20price%20discrimination%2C%20and,to%20reduce%20pharmacy%20price%20variations\">vary<\/a> by as much as $719 for the same 30-day prescription even when prices are publicly listed.<\/p>\n<p><strong>What can also be done?<\/strong><\/p>\n<p>Creating a consistent national framework could replace the current patchwork of state laws and improve oversight of how drugs are priced. For example, the\u00a0<a href=\"https:\/\/www.congress.gov\/bill\/119th-congress\/house-bill\/2450\/text\">Drug Price Transparency in Medicaid Act<\/a><em> (H.R. 2450) <\/em>could do just that: it would standardize reporting requirements and reveal how drug prices are set, rebated, and reimbursed. But transparency alone can\u2019t lower costs\u2014it only shows the problem.<\/p>\n<p>To make transparency meaningful, policymakers must <a href=\"https:\/\/law.pacific.edu\/sites\/default\/files\/users\/user242\/ernst-tuoplr-513.pdf\">address<\/a> the underlying contracts and incentives that drive high prices. <\/p>\n<p><span><\/span><\/p>\n<p><a href=\"https:\/\/schaeffer.usc.edu\/research\/the-association-between-drug-rebates-and-list-prices\/\">Hidden rebate deals<\/a> and <a href=\"https:\/\/oversight.house.gov\/wp-content\/uploads\/2024\/07\/PBM-Report-FINAL-with-Redactions.pdf?utm_source=\">opaque pricing structures<\/a> between PBMs and drugmakers often inflate costs and limit patients from seeing savings. Transparency legislation should also be paired with <a href=\"https:\/\/www.americanprogress.org\/article\/value-based-pricing-prescription-drugs-benefits-patients-promotes-innovation\/\">value-based pricing<\/a> that links payments to clinical benefits. Federal programs like the <a href=\"https:\/\/www.cms.gov\/priorities\/medicare-prescription-drug-affordability\/overview\/medicare-drug-price-negotiation-program\">Medicare Drug Negotiation Program<\/a> provide additional leverage, but broader reforms are needed to reach the <a href=\"https:\/\/www.rand.org\/pubs\/research_reports\/RRA1820-3.html\">commercial market<\/a> (i.e., where most Americans get their prescription drugs and still face high prices).<\/p>\n<p>Still, transparency can have <a href=\"https:\/\/link.springer.com\/article\/10.1186\/1744-8603-10-34\">downsides<\/a>, especially globally. Fully public drug prices could push companies to stop <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5691843\/?utm_source=chatgpt.com\">offering lower prices<\/a> in low- and middle-income countries. To avoid cross-country comparisons, they could <a href=\"https:\/\/d1wqtxts1xzle7.cloudfront.net\/98229159\/OHE_20CGD_20Research_20Report_20Price_20Transparency_20Final_2028_20March_202019_20v2-libre.pdf?1675526715=&amp;response-content-disposition=inline%3B+filename%3DThe_Future_of_Global_Health_Procurement.pdf&amp;Expires=1759764510&amp;Signature=VeC97jqVTm-4SXdRjb-gCfU9v9AJ2HJKi7S9D7rwtsnJg5f5HS-OjzUfaRO2CHleDr7mcih~5r0zh9ULQlQopp3LMYbeBxWGA0k61wtGXqNy9JfagSFQ8YpB4YChfqp0VN1GMg5U~OhBWKT5c1-77fUZkhNB7JQ9lH5WbVUFMaIfzP8kgN1eYU9v5VUcrZg264VbGG~RHBntCfjLG0c9AmqpEfZgfXjHp05mbaJSyPa8JgykSczYPlHuIuHrmqpGEkLvac9IwUfhCOuI-gxPVg96ijK4tiiaATTYnkWZyVN1Qk7A~msGG0afNuPoEL6EMJBTHtPjqpCE4JGcxO5p2Q__&amp;Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA\">raise prices<\/a> across the board, making medicines less affordable where they\u2019re needed most. To make transparency more equitable, policymakers should combine disclosure with protections that preserve affordability worldwide.<\/p>\n<p><strong>Conclusion<\/strong><\/p>\n<p>In short, transparency is necessary but an incomplete fix for America\u2019s drug pricing system. Simply shining a light on how prices are set isn\u2019t enough. Policymakers need to be paired with other reforms, such as removing the incentives that encourage high prices, holding PBMs and manufacturers accountable, extending the negotiating power beyond Medicare, and protecting prescription drug access both at home and abroad. Without these other steps, transparency laws risk highlighting unfairness without actually improving it.<\/p>\n<p><em>PhiYen Nguyen, MPP, and\u00a0<\/em><em>Kristina Smith, MSW<\/em>\u00a0are both senior policy analysts at the Partnered Evidence-based Policy Resource Center, a partnership with Boston University School of Public Health. <em><\/em><em> (Kristina\u2019s last name was Carvalho in her previous THCB appearance)<\/em><\/p>","protected":false},"excerpt":{"rendered":"<p>By KRISTINA SMITH &amp; PHIYEN NGUYEN Policymakers and advocates often promote drug price transparency to lower costs and improve equity. While transparency is an important first step toward accountability and informed public budgeting, it does not guarantee affordable prices or fair access to medicines. Transparency Has Some Benefits Drug price transparency helps show how and&#8230;<\/p>\n","protected":false},"author":0,"featured_media":9739,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-9740","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/9740"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9740"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/9740\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/9739"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9740"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9740"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9740"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}