PRA Leads Consortium of Tech Firms to Develop Prescription Drug Price Transparency Recommendations

PRA led a group of tech firms and healthcare price transparency advocates to send a strong message to federal health officials: It's time to finally implement full prescription drug price transparency.

In an RFI addressed to key cabinet officials, PRA and this tech consortium urged the government to finish the job it started under the Transparency in Coverage (TiC) rule -- specifically, by finalizing and enforcing a requirement for health insurers to publish machine-readable files that show the actual prices of prescription drugs -- and provided specific recommendations to best do so.

Read the full RFI and detailed recommendations.

These Rx Machine-Readable Files (Rx-MRFs) can protect patients from overcharges and give them the power to compare prices and reduce inflated costs through choice and competition. But despite being part of the original TiC rule, implementation has lagged.

The letter outlines a series of practical steps to ensure meaningful transparency:

• Remove the 20-claim threshold that currently hides prices for many expensive or rare drugs. Patients need access to prices on all drugs, not just the most common ones.

• Standardize how dosage and supply periods are reported, so people can fairly compare the cost of 30-, 60-, and 90-day prescriptions.

• Break down the real price structure—including ingredient costs, dispensing fees, PBM (Pharmacy Benefit Manager) markups, and more—so we can see where our money actually goes.

• Disclose hidden relationships between PBMs and pharmacies, which often distort pricing and create conflicts of interest.

With the right data in the right format, technology companies can create easy-to-use apps and platforms that enable patients to compare drug prices just like they do flights or hotel rooms. PBMs and insurers will no longer be able to profiteer through obfuscation.