HHS ‘plan to cut prescription drug costs is a good start, but we need bold and swift action

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September 14, 2021

7 minutes to read

Disclosures: Kuwahara reports serving on the National Steering Committee for Prescription Drug Affordability at Doctors for America.


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HHS recently announced a plan support legislation that would allow it to negotiate the prices of Medicare Part B and Part D drugs directly with drug companies, and then make those prices available to other buyers, in addition to other key policy proposals to reduce drug costs. medications.

In this guest editorial, Rita K. Kuwahara, MD, MIH, a primary health care policy researcher and internal medicine physician at Georgetown University, discusses the HHS plan and explains how affordable drugs would allow providers to focus on responsive care to preventive medicine, which in turn would improve health outcomes and lower overall health care costs.

As a primary care physician, I have seen firsthand how access to affordable medicines can mean the difference between life and death for my patients.

For my diabetic patients who need insulin to survive, it is unacceptable that their ability to live or die depends on the type of drug coverage they have and whether they can afford the sky-high cost of it. insulin.

We are at a critical time when our nation has the capacity to make medicines affordable for all, but it is essential that we put health before politics and show that as a nation we aim to ensure that everyone can. access the medicines they need when they need them.

The Biden-Harris administration is to be applauded for its leadership and commitment to lowering prescription drug prices. This is an important first step, but much more can and must be done, and the administration has the power to do it.

Every person in our country needs access to affordable medicine now, and we cannot afford to wait. We are currently in the midst of a pandemic, which has made essential medicines financially inaccessible to many people who have lost their jobs and employer-sponsored health insurance, and inaction will cost lives.

Pharmaceutical companies have for too long taken advantage of people’s poor health and benefited from generous policies that allow their profits to grow unchecked. For example, pharmaceutical companies set the prices of drugs; Unlike other high-income countries, the United States does not negotiate these prices, resulting in prescription drug costs 2.5 times higher than those of other high-income countries, according to a report by the RAND Corporation. What’s more, even during the pandemic, a recent AARP report found that “between 2019 and 2020, the retail prices of 260 widely used brand-name prescription drugs increased 2.9%, more than two times faster than general inflation “.

While I hope Congress is able to come together and pass comprehensive legislation to make drugs affordable for everyone in our country, it is essential that the administration use all the powers of the executive to ensure that everyone has access to affordable products, life-saving medicines whenever they need them, because disease is never planned and health should not be a commodity, but rather a human right.

It makes sense that in a free market economy Medicare would be able to negotiate the prices of prescription drugs, and since drug companies already benefit from public funds that support initial drug development, mechanisms should be in place to limit additional patient expenses – out-of-pocket costs for prescription drugs.

In the current model, it is important to note that patients often end up paying two to three times for their medication. They pay first through their taxes which support NIH funding, since the 356 drugs that were approved by the FDA between 2010 and 2019 were supported by NIH funding. Our patients are paying a second time through their health insurance premiums, which continue to rise with the rising cost of health care in the United States. They are then billed a third time when they collect their medication from the pharmacy.

The unreimbursed drug costs that families pay at the pharmacy counter have also increased, as co-payments increasingly depend on drug pricing, rising health insurance deductibles, and the increasing shift in drug use. co-payments to the percentage of coinsurance owed by patients to purchase their prescription drugs.

Since access to affordable medicines is essential for maintaining good health, we need bold and decisive action now to lower the cost of prescription drugs and make drugs affordable for everyone so that each of our patients and everyone in our community can access the medicines they need.

As a member of the National Steering Committee for Prescription Drug Affordability at Doctors for America, my colleagues and I have continued to advocate for strategies to reduce drug costs for our patients through executive action and legislative.

During HHS Secretary that of Xavier Becerra confirmation process earlier this year, Doctors for America sent key questions about drug affordability to the Senate Finance Committee to ask Becerra, highlighting some of the issues the administration has the power to act on. This included advocating for the use of “the federal authority to demand treatments and vaccines for COVID-19 to ensure affordable access for all”, the commitment “to all mechanisms available (e.g. market rights, Section 1498, Defense Production Act) to ensure that Americans don’t continue to receive a bad deal from drug companies that deny access to treatments and vaccines lifesavers of which they are true investors, “ensuring that” the NIH and the FDA apply sanctions for failure and delay in reporting clinical trial results, “supporting” efforts to ensure that Medicare and other insurers can negotiate directly with pharmaceutical companies to reduce the cost of all prescription drugs “, and” offering a total of 5 years of exclusivity for all biologic drugs s instead of the current 12 years that have led to exorbitant monopoly prices for these treatments.

These concrete proposals, some of which have already been adopted by the administration, represent examples of policies that can be used to create a framework of action that the administration can take to reduce prescription drug costs for everyone in our region. country.

It is not fair that our current system prioritizes profits over health, which leaves us with patients every day who cannot afford their drugs. We urgently need access to affordable medicines for all to improve the health of our nation.

This is even more evident during the COVID-19 pandemic, with many families no longer able to afford necessary medications due to financial exhaustion and loss or change in insurance coverage. At the same time, however, the COVID-19 pandemic has given us insight into how we can improve public health and the health of our communities if we make health care accessible and affordable for all.

For the first time as a practicing physician in the United States, when patients come to me and need to be vaccinated against COVID-19, I can now tell them that they can get the vaccine regardless of the type of insurance. , their ability to pay and how much money is in their bank account simply because as taxpayers they have already paid for the development, purchase and distribution of COVID-19 vaccines, and the vaccines, purchased by the government with taxpayer money, are now available without sharing additional costs for the sick. This has been essential, especially as we are trying to increase immunization rates to keep everyone safe. If only we had the same luxury of being able, for example, to ensure that diabetic patients have access to insulin, we wouldn’t have people with diabetes who die or develop serious complications because they have to ration or forgo completely. take their insulin because of the cost.

Regarding COVID-19 vaccines, given that the government and taxpayers have already invested significant funds in the development and distribution of vaccines, the government should have the capacity to negotiate the price of vaccines because of large-scale vaccination campaigns. are organized across the country. in an effort to curb the current pandemic, rather than having to pay increasingly higher prices for vaccines as manufacturers arbitrarily raise prices, which will ultimately increase health spending and costs to taxpayers.

It is essential that we as a nation make medicines affordable for all, so that we can practice preventive medicine rather than reactive care and in doing so reduce overall health care costs with a focus on improving health outcomes so that everyone is healthy enough to live, work and care for their families.

As physicians, we need to give our patients a voice and use our power to communicate the experiences of our patients who cannot afford essential medicines to advocate for pricing policy reform. prescription drugs.

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Editor’s Note: This interview reflects the views and opinions of Kuwahara and not its affiliations or institutions.


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