Proposals for Change: Transparency, Competition and Value

The Campaign for Sustainable Rx Pricing (CSRxP) has announced the release of market-based policy solutions to curb rising drug prices. The campaign’s solutions focus on three main themes – transparency, competition, and value – aimed at fixing the broken prescription drug market.

“The strength of CSRxP is the diversity of members who have come together to advance solutions that address rising prescription drug prices,” said John Rother, president and CEO of the National Coalition on Health Care and executive director of CSRxP. “Our solutions have the support of hospitals, physicians, pharmacists, nurses, health plans, patients, and employers.”

The release of CSRxP’s policy platform coincided with a panel discussion with representatives from the American Hospital Association, AARP, American College of Physicians, and Kaiser Permanente. The panel highlighted the need for more information about the true costs of treatment, how the price of medication is set, and how much it actually costs to bring new drugs to market. Participants also noted the importance of increasing transparency for patients, doctors, and payers throughout the health care system to make more informed decisions about medications, particularly those with high price tags.

“We are proud to work with this diverse group to bring forward thoughtful solutions to make prescription drugs more affordable for the than 1.1 million associates and family members on Walmart’s health care plans and the millions of customers that visit pharmacies in our stores and clubs each week,” said Sally Welborn, senior vice president of global benefits at Walmart.

“AARP’s more than 37 million members and their families should not be breaking into a cold sweat every time they step up to the pharmacy counter to pay for their prescription drugs,” said Dr. Debra Whitman, chief public policy officer at AARP.  “Prices are out of control and affecting everyone – even if you don’t need prescription drugs, you are paying part of the cost through your health insurance premiums or taxes. We cannot afford to do nothing about prescription drug costs.”

CSRxP’s solutions come at a critical inflection point. Today, prescription drug prices are close to 20 percent of health care costs in America, and growing faster than any other part of the health care system.

“The high cost of prescription drugs is straining the entire health care system, including hospitals, health systems and our patients,” said Rick Pollack, American Hosptial Association president and CEO. “These proposed policies are a good start to addressing the problem by increasing transparency and promoting competition, innovation and value.”

“At Kaiser Permanente, we do everything in the health care space from seeing patients and negotiating with drug companies to filling prescriptions and researching drug adherence,” said Bernard J. Tyson, Chairman and CEO of Kaiser Permanente. “In addition, a majority of our patients stay with us for a long period of time. These factors allow us to see the entirety of how the health care system works. We appreciate the potential value of prescription drugs, yet we view high drug pricing trends as a threat to affordability and accessibility. The pricing is an aberration in a health care system which is otherwise committed to transforming itself to ensure affordability, and undergoing changes to pay for results and outcomes. Simply put: the drug companies must recognize that they are part of this larger health system and that their pricing decisions affect individuals, families, governments and purchasers. The specific policy proposals put forward by the Campaign for Sustainable Rx Pricing (CSRxP) are important first steps towards lowering prescription drug prices in the United States.”

Addressing the unsustainable cost of prescription drugs is a bipartisan issue. Both Republican and Democratic candidates have made rising drug prices a top priority on the campaign trail in response to voter demand for solutions.

“Survey after survey shows the American people are outraged over the rising cost of prescription drugs. They are demanding action,” said Chip Kahn, president & CEO of the Federation of American Hospitals. “This effort is a game changer – an unprecedented coalition of consumer groups, providers, insurers and employers coming together to seek practical, market-oriented solutions designed to make prescription drugs more affordable. The alarming, unnecessary and unjustified cost growth for both brand name and generic drugs is placing undue stress on patients and caregivers alike. The proposals announced today are intended to have a meaningful impact and should help improve access and lower the cost of care for patients.”

“The problems associated with escalating drug prices are complex and merit a thoughtful discussion,” said Paul Abramowitz, CEO of the American Society of Health-System Pharmacists (ASHP). That’s exactly why ASHP has taken on this issue as a top priority on behalf of our members and their patients. We are pleased that the Campaign for Sustainable Rx Pricing (CSRxP) has brought together diverse stakeholders and sparked a national dialogue to identify policy solutions that will improve the market for prescription drugs and make medicines more affordable to patients.”

When patients cannot afford their medications, doctors often worry about patients trying to save money by skipping doses or cutting pills in half. According to the Centers for Disease Control and Prevention, one in 10 Americans don’t take their medications as prescribed because of the cost.

“As internal medicine physicians who specialize in the treatment of adults and adolescents, many with chronic illnesses, American College of Physicians (ACP) members see on a daily basis how the rising cost of prescriptions causes their patients not to keep up with the recommended medication schedule or even forgo filling their prescriptions,” said Bob Doherty, senior vice president of governmental affairs and public policy for the American College of Physicians. “Today’s announcement that physicians, consumers, hospitals, nurses, employers, and many others have joined together to recommend consensus solutions will give them hope that rising drug prices no longer need be a barrier to their patients getting the medications they need, at a price they can afford.”

“Soaring drug prices are a very real issue for many Americans — sometimes even detrimental to patients. Everyone in the industry needs to work toward solutions that help people get the medicine they need at a price that is affordable and sustainable,” said Jim DuCharme, president and CEO of Prime Therapeutics. “As the only pharmacy benefit manager that’s a member of CSRxP, Prime is working with coalition members to drive more competition, transparency, and value as those strategies can close the big gaps in today’s healthcare system that are fueling out of control drug prices.”

Summary of Policy Recommendations

CSRxP’s policies provide a roadmap for policymakers who are serious about making prescription drugs affordable for patients and families. The Campaign recommends promoting more competition in the prescription drug market and advises providing the U.S. Food and Drug Administration (FDA) with additional resources so it can approve generic drugs more quickly – especially in cases where an expensive drug has no alternative on the market.CSRxP also believes it should be easier to bring a drug to market and exclusivity protections should only be used for new, innovative products. Additionally, the group recommends that patients have access to more information about how different medications compare in efficacy to help bring prices down and empower patients to pay for what works.

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