Fact check: Facebook post touting decreasing drug prices under Trump is misleading

Ian Richardson, USA TODAY
·10 min read
  • Oops!
    Something went wrong.
    Please try again later.

The claim: Under President Donald Trump, prescription drug prices have seen year-over-year declines in nine of the last 10 months

A Facebook post comparing President Donald Trump’s record on prescription drug price increases to the eight years under former President Barack Obama went viral during the weeks leading up to and following the presidential election.

The Oct. 16 post from Facebook user Krystal Roberts claims that prescription drug prices averaged a 3.6% year-over-year increase during the eight years preceding Trump’s inauguration.

It then claims drug prices have seen “year-over-year declines in nine of the last 10 months, with a 1.1% drop as of the most recent month.” It also says in June 2019, the U.S. had “the largest single-year drop (2.0% year-over-year decline) in prescription drug prices since 1967.”

As of Wednesday afternoon, the post had 7,100 shares and more than 25,000 reactions. The post has since been deleted.

Roberts' post was originally published on social media by the account "Red Pill Fairy," which posted it to Facebook and Instagram on Sept. 7. Red Pill Fairy’s website describes itself as “right-wing content the mainstream liberal media refuses to publish.” Those social media accounts have since been removed from both platforms. A post on the Red Pill Fairy website said Nov. 19 that the accounts had both been banned.

Roberts did not respond to a USA TODAY request for comment. Contact information for the Red Pill Fairy accounts was unavailable.

More: Fact check: What's true and what's false about coronavirus?

Measuring prescription drug prices

Prescription drug prices are hard to measure because of the complexity of the supply chain that surrounds them.

Juliette Cubanski, deputy director of the Program on Medicare Policy for the Kaiser Family Foundation, said she doesn't believe there's "one perfect way" to measure the changes in prescription drug prices.

"It can be difficult to get a handle on what even is 'price' when it comes to prescription drugs," she said. "There are list prices that manufacturers may charge, but then there are prices that people actually pay out of pocket after you take into account rebates and other discounts that are negotiated between insurers and pharmaceutical companies."

Fact check: More than 40 patients receiving treatment in converted hospital parking garage

The Facebook post doesn't specify what it means when it refers to "drug prices." However, the wording and statistics in the posts appear to come nearly word-for-word from a White House news release issued Nov. 5, 2019. The release, "Prescription drug prices are falling at historic levels thanks to Trump administration policies," linked to a paper by the Council of Economic Advisers that it said showed prescription drug prices were "decreasing at rates not seen since the 1960s."

The report uses the Consumer Price Index for prescription drugs, which is compiled by the U.S. Bureau of Labor Statistics.

According to the BLS, the CPI’s prescription drugs index, or CPI-Rx, measures “price change of drugs purchased with a prescription at a retail, mail order, or internet pharmacy.”

"The tracked price is the total reimbursement to the retailer from the patient and all eligible payers for a single prescription," the BLS says on its website. "Payers are any entities who reimburse health care providers for the cost of medical services and/or goods. Eligible payer types for prescription drugs are: patient self-pay (cash), commercial or private insurance and Medicare Part D."

To determine this, the CPI-Rx uses a sample of retail pharmacies. To track prescription drug prices, it takes a sample of the last 20 prescription drugs dispensed at each of the pharmacies.

At the time of the news release, BLS data showed that between December 2018 and September 2019, the CPI-Rx had decreased in nine of the 10 months. The most recent data at the time, from September 2019, showed a year-over-year decrease of 1.1%.

The data also showed that in June 2019, the CPI-Rx saw approximately 2% drop from the previous June — the largest year-over-year drop since December 1967, which saw a 2.1% drop. This data matches the claims in the Facebook post.

Both the Facebook post and the White House news release cited data showing the CPI-Rx averaged a year-over-year increase of 3.6% each month between February 2009 and January 2017, the eight years before Trump took office.

But CPI-Rx data varies from month to month, and the measure has also increased during Trump's term. In fact, despite the stretch of decreases mentioned in the Facebook post, the CPI-Rx has averaged a year-over-year increase of 1.5% between February 2017 and October 2020. October is the most recent month with data available.

Experts: CPI-Rx 'misses a lot of key facets'

The White House news release says the CPI-Rx "is the best available measure of overall price changes for retail prescription drugs." But experts told USA TODAY that it's an imperfect metric for looking at drug prices as a whole and excludes some of the highest-priced drugs.

Michael Rea, the founder of Rx Savings Solutions, said the CPI-Rx doesn't take into account many high-cost specialty drugs that aren't commonly dispensed in retail pharmacy settings.

While it's better to see the CPI-Rx going down than up, he said, the data doesn't offer a complete picture of the facts.

"If you're only including mostly generic drugs dispensed at the corner Walgreens, that's not going to give you a true view of all prescription drug costs, which do include those high-cost specialty drugs, compounding drugs — things like that," he said.

The CPI-Rx also limits itself to cash transactions, while many transactions are now conducted electronically, Cubanski said. It also doesn't factor in the rebates negotiated between insurers and pharmaceutical companies, which can be substantial.

Cubanski said even though the CPI-Rx may show a moderation in price increases, overall spending on prescription drugs doesn't appear to be decreasing, she said.

"I think while we might say that yes, prescription drug spending growth has moderated — so it's not growing as quickly as it did in the past — it's not declining," she said. "The absolute level of prescription drug spending is not going down."

The "big picture" of drug prices can also be misleading, she said, because generic drugs, which are the vast majority of prescription drugs used in the U.S., are generally decreasing in cost while brand-name drugs are increasing. Many new drugs coming onto the market have very high prices, she said.

Fact check: Politicians on both sides of the aisle have flouted COVID-19 guidelines

According to the Washington Post, a 2018 study by the National Bureau of Economic Research said the growing market share of generic drugs could skew the CPI-Rx data. That was among the concerns raised in the study about the metric.

"The vast majority of spending is on brand-name products," Cubanski said. "If you just look at the brand-name products alone, you're going to see a different story than if you're looking at a bigger picture that is more heavily weighted by the generic drug transactions."

Antonio Ciaccia, CEO of the nonprofit drug pricing education organization 46brooklyn Research, said he believes the CPI-Rx also uses too small of a random sampling of the drugs sold at pharmacies, which further limits the picture. He said the overall picture of drug spending is multifaceted and depends on what drugs the consumer is buying.

"CPI-Rx misses a lot of key facets of the pharmacy marketplace," he said.

Ciaccia said 46brooklyn's research has shown the number of brand-name drugs that are increasing in price has slowed over the last few years, and those drugs that are increasing are going up by less money. But, like Cubanski, he said new brand-name drugs are entering the market at higher launch prices.

While the percent price increase may be slowing for brand-name drugs overall, he said the average cost of the drugs that are seeing price increases is accelerating.

"It's complicated and nuanced and unable to be digested in a five-line meme on the internet," he said.

CPI-Rx data in the Facebook post is outdated

Criticisms of the CPI-Rx aside, the Facebook post doesn't present a reference point for the source of the data it uses. That means it's giving readers an outdated picture of the current trajectory of the CPI-Rx itself.

The post claims prices have seen year-over-year decreases in nine of the last 10 months, which was true when the White House published its news release. But in the 13 months since then, the CPI-Rx has had a year-over-year decrease only once. That decrease came in October of this year, when the CPI-Rx decreased 0.4% from the previous year.

That means the reference in the post to the "most recent month" would also be incorrect because it says the most recent decrease was 1.1%. The October data would not have been published yet in September, when Red Pill Fairy made the original post to social media.

Our ruling: Partly false

The Facebook post makes a broad claim about the trajectory of "prescription drug prices" without providing context on the source of its data or what date ranges many of the quoted figures represent.

The post appears to be using CPI-Rx data. Experts interviewed by USA TODAY say is an imperfect indicator of drug prices that leaves out some important measurements, such as the prices of many high-priced specialty drugs. A decrease in the CPI-Rx is better than an increase, but a discussion only using this metric is incomplete, they said.

While the Facebook post does accurately quote the CPI-Rx data shared in a White House news release from November 2019, the data was approximately one year out of date by the time either of the two Facebook accounts posted the information.

The CPI-Rx has shown year-over-year increases, not decreases, for the past several months since then, only showing a slight decrease in October 2020.

For these reasons, we rate this post as PARTLY FALSE.

Our fact-check sources:

Ian Richardson covers the Iowa Statehouse for the Des Moines Register. Reach him at irichardson@registermedia.com, at 515-284-8254, or on Twitter at @DMRIanR.

Thank you for supporting our journalism. You can subscribe to our print edition, ad-free app or electronic newspaper replica here.

Our fact check work is supported in part by a grant from Facebook.

This article originally appeared on USA TODAY: Fact check: Post on decreasing Rx drug prices contains outdated info