PRESCRIPTION FOR CHANGE: WHY DRUG PRICES ARE OUT-OF-CONTROL AND HOW TO FIX IT

CSRxP Briefing Covers Impact of Affordability Crisis, Drug Company’s Price-Hiking Practices and Bipartisan, Market-Based Solutions

The Campaign for Sustainable Rx Pricing (CSRxP) hosted a briefing, “Prescription for Change: Why Drug Prices Are Out-of-Control and How to Fix It,” on Wednesday.

CSRxP was joined for the briefing by a panel of leaders representing hospitals, physicians, health plans and consumers, who spoke to:

• The impact of out-of-control drug prices on American patients, taxpayers and the health care system, particularly in the time of COVID-19.
• How Big Pharma’s anti-competitive and price-gouging practices created and sustain a crisis of prescription drug affordability in the United States.
• The bipartisan, market-based solutions Congress can advance to hold Big Pharma accountable, lower prescription drug prices and deliver much needed relief for American patients and taxpayers.

Lauren Aronson, Executive Director of the Campaign for Sustainable Rx Pricing outlined how the egregious price-hiking behavior of Big Pharma has created a crisis of affordability and how out-of-control prices negatively impacted everyone from consumers to providers to health plans:

“We’re in the midst of a global pandemic. We’re in the midst of an economic crisis, and we are seeing manufacturers continue to increase prices as if nothing has changed. And it really presents a challenge for consumers, payers, physicians and hospitals. These incremental increases we’re seeing – I think by our count there are over 580 increases on prescription drugs, on the brand side, just in January alone. And when you’re thinking about what the impact of that is for a Medicare beneficiary who’s living on a fixed income or a physician who’s trying to manage these costs or a hospital or a plan, there’s nothing else that can be done here except to absorb it, and the only entity that’s benefitting from this is the pharmaceutical industry.”

Bill Sweeney, Senior Vice President of Government Affairs for AARP highlighted the impact of out-of-control prescription drug prices on seniors, especially during the COVID-19 pandemic:

“This is a pocketbook issue that older Americans feel. The anger and the frustration they feel, I cannot tell you enough, is that they see the price of their prescription medications go up year after year after year and that has not subsided due to the pandemic.”

Sweeney also noted strong, bipartisan support that exists for market-based solutions and highlighted the urgent need for Congress to take action on the issue:

“We live in an era of unbelievable partisanship where Americans can barely see eye-to-eye on anything and yet this issue is one of the few that unites Republicans, Democrats and Independents. Your Republican constituents are just as angry and furious about this as Democrats and Independents are. And they’re also outraged that for years they’ve heard about this from Washington and yet no one has solved the problem.”

Stephanie Quinn, Senior Vice President for Advocacy, Practice, Advancement & Policy at the American Academy Of Family Physicians spoke about the tremendous public health implications when Americans cannot afford their medications:

“40 percent of the adults in this country have two or more chronic conditions. Many of those are controlled through medication and once you layer on top of that the economic pressure and instability that the pandemic is causing, there’s a perfect storm to see this huge backslide in terms of the gains we’ve made in terms of population health. So, as we work towards population health, you can’t achieve that unless you meaningfully address the cost of drugs.”

Quinn explained that when drug companies’ game the system, it is patients and health outcomes that lose:

“There are a lot of gimmicks in the system, a lot of ways to get around kind of fair play, and the ones left holding the bag are patients. All of these things obscure the true cost and in the end the patient is the one getting squeezed. That’s our frustration. Physicians are asked to take on greater ownership of the patients care and outcomes, and this is something they can’t control for them, and it’s frustrating.”

Lynn Eschenbacher, Chief Pharmacy Officer & Vice President Of Medication Management for Ascension spoke about how Big Pharma’s price increases impact health systems and clarified a common misconception that drug companies offer ubiquitous discounts for large systems — highlighting how a lack of generic and biosimilar competition allows manufacturers to engage in monopoly pricing:

“The fact is manufacturers are only willing to negotiate the price for about half the drugs that we buy. We have no leverage in terms of drugs that have no competition and manufacturers know this. When the cost of a drug spikes, we explore other low-cost alternatives while ensuring that we don’t compromise patient care. If that’s not possible and there aren’t clinical alternatives, we’re forced to absorb that higher cost of the drug.”

Eschenbacher highlighted the benefits of bringing more affordable alternatives to market, especially biosimilars:

“When we look at our biosimilars, and we’ve seen a few come to market, and the uptake has been increasing, we can see a dramatic difference in the cost of the medication…it is crystal clear that when there are more in the market, we can negotiate and its better for our patients all around.”

Eschenbacher also discussed the importance of public policy solutions to increase competition and protect the 340B program:

“We urge policymakers to speed approval of lower-cost generics and biosimilars. We’ve seen in our data, that when there is competition, we can achieve savings between 20 and 60 percent and on average about 40 percent. We also urge policymakers to protect the 340B program. Manufacturers are trying to avoid offering 340B discounts to safety-net facilities, and with drug prices being as high as they are today and rising, the 340B program is as important as ever.”

Sameer V. Awsare, MD, FACP, Associate Executive Director of The Permanente Medical Group, Kaiser Permanente, spoke about the impact the crisis of prescription drug affordability on patients:

“I try to think of it from my patients’ viewpoint. What good is it if there are life changing medications that I can’t afford? There’s just no value. As a patient or physician, what do we want? We want our population to get healthier. If they can’t take their medications, they can’t get healthier.”

Awsare pointed to the need for greater transparency into pharmaceutical pricing:

“It would be great to understand why those prices go up. Everything else in healthcare is transparent. You can log onto the internet and look up my hospital and it will tell you how we perform in terms of care of patients with heart attacks, pneumonia, hypertension control, it’s all there. When [prescription drug] prices go up several times a year, there’s really no indication what happened there. Some of these drugs were created ten years ago. Did the cost of manufacturing go up that much? Some of them started out at $10,000 and they’re $60,000 today, for some of the specialty drugs. I, as a physician, and my patients would really like to understand why those costs are going up.”

Learn more about the crisis of out-of-control prescription drug prices and bipartisan, market-based solutions to hold Big Pharma accountable HERE.