One thing that most administrations tend to agree upon is the desire for transparency in prescription drug prices.

In line with nearly every other political ideology (across the world — not just the U.S.), the major issue here is that while different parties might have the same goal, the way in which they choose to accomplish that goal may not be the same. They may not even be in the same ballpark.

Where some political parties will want to create regulations requiring companies to release their retail prices (and any changes to those prices), others might want to strongly encourage them to do so.

One of the final things the Trump administration did before the Biden Inauguration was to sign a rule they called Transparency in Coverage. This rule requires insurers to disclose the price of medication — not just current prices, but historical prices, as well. Additionally, insurers are required to provide personalized cost-sharing information to each enrollee.

For example, let's say that your Advair Diskus inhaler for asthma cost the insurance company $150.00 and they were charging you $25.00. This leaves their portion set at about $125.00, and they would be required to relay that information to you, the insured.

This might seem easy enough, since in most other industries, there is a set retail price that consumers can expect to pay. But in healthcare, this isn't the case at all. Finding the actual retail price of an insured drug is nearly impossible, and if you research prices at five different pharmacies, you're likely to find five different prices.

Unsurprisingly, pharmacy benefit managers (PBMs) and insurers are trying to fight this rule.

Consumer Choice

One of the "perks" of having a consumer-driven insurance model (meaning that people can choose their insurance plan, where they purchase their medications, and sometimes which medications they take) is that people supposedly have more control of their healthcare decisions. While this may be true in theory, this model tends to fail without price transparency.

For example, if you're trying to choose between a high deductible health plan (HDHP) and a more traditional premium-plus-copay model, it would be difficult to tabulate your expected medical and prescription expenses without knowing what each of those things costs. How much does it cost to give birth to a child? How much does your Xarelto cost per month after factoring in the insurance covered portion of the drug? These are valid questions with complex answers.

The truth is that price transparency is a problem throughout the American healthcare system. Prescription drug prices are only one facet of this problem, so even as prices become more transparent, there are still plenty of areas in which this philosophy needs to filter.