Every Voice Counts
[March 2020 | By Marilynn Huseby, Senior Resource Consultant]
Medicare Part D was created in 2003 to provide a low-cost drug plan that would help older Americans afford the expense of their prescription drugs. Since that time, drug have increased threefold.
Here is a common story. A woman who was diagnosed 15 years ago with Type 1 diabetes, was told that if she was willing to manage her diet and take insulin, she could have a long life expectancy. In that period of time, neither her dose nor her frequency use has changed.
But the cost has. Her insulin expense jumped from $70 a month to $600. The price increase is a glaring statement about this issue for people who take medication and live on a fixed income. Has her plan, supposedly crafted to help reduce Rx costs, actually contributed to pharmaceutical company greed?
Since 2015, retail prices for more than 750 prescription drugs commonly used by older adults has increased annually by approximately 6.4 percent. “Drug companies are making billions in profits off seniors. It’s just wrong, and something has to change,” said Senator Karen Keiser (D-Des Moines, Iowa), a longtime member of the Senate Health and Long-term Care Committee. “We need to hold drug manufacturers and insurance companies accountable for these skyrocketing prices.”
Senate Bill 5292 was passed unanimously by both Democrats and Republicans, recognizing the urgent need for drug company transparency and control.
The House of Representatives recently passed H.R.3, the “Lower Drug Costs Now Act,” with all Democrats and all but two Republicans voting yes. The measure now goes to the U.S. Senate, where lawmakers are considering SB 5292, a bipartisan bill, to reign in the cost of prescription drugs.
SB 5292 requires the Health Care Authority (HCA) to compile an annual list of 10 prescription drugs that are significantly critical for public health. Currently, the manufacturers can charge whatever they want. The insulin drug, Lantus, for example, now costs almost four times as much in the U.S. as it costs in Canada and the United Kingdom. Lucentis, a drug used to treat macular degeneration, costs seven times as much in the U.S. as in France. Under the new negotiated bill, the secretary of Health and Human Services (HHS) would identify 250 drugs that will not be allowed to be priced more than 1.2 times the average price of the same medication in six other countries: Australia, Canada, France, Germany, Japan, and the United Kingdom. If a drugmaker refuses to negotiate or a fair price is not reached, it would have to pay a penalty equal to 65 percent of that company’s annual gross sales!
Once the manufacturer agrees on the drug price, the company would not be allowed to increase the price faster that the rate of inflation, as long as there are no generic competitors. Further discussions of the Senate Finance Committees would be to cap annual, out-of-pocket prescription drug expenses for Medicare beneficiaries at $2,000 annually.
Lawmakers will consider drug-pricing bills that are similar to what states have adopted, such as the law passed in Colorado last year, which caps a patient’s out-of-pocket cost for insulin at $100 for a 30-day supply.
Other possible measures would allow state employees to get prescriptions filled in Canada and Mexico.
How can we all help shift the pharmaceutical industry’s focus from greed to helping patients’ needs for treatments that are best suited for their problems? A survey done by AARP’s “Stop Greed” campaign found that 40 percent of patients surveyed said that they did not fill at least one prescription prescribed by the doctor because of the cost. One way to make a difference is to share stories about your own struggles paying for prescription drugs. Call 866-227-7457 or email firstname.lastname@example.org to find out more. You can also go to WashingtonVotes.org to make sure as many legislators as possible from us about our health needs. Every Voice Counts. *