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Here's why drug prices are so high (2018)
01:45 - Source: CNN Business

Editor’s Note: Jo Ann Jenkins is CEO of AARP and based in Washington DC. The opinions expressed in this commentary are the author’s. View more opinion articles on CNN.

CNN  — 

In an all-too-rare example of political consensus, congressional lawmakers on both sides of the aisle appear to agree – at least in principle – that something needs to be done about out-of-control prescription drug prices. That’s a good thing for just about everyone, except perhaps drug makers. The question now, though, is whether the principle will be put into practice.

If the recent Senate Finance Committee hearing in which the CEOs of several drug industry titans were called before Congress is any indication, big pharma will use its massive profits and lobbying clout to oppose any serious attempts to lower drug prices. After all, they’ve got a good thing going.

Jo Ann Jenkins

Consider, for example, a recent study by the Public Policy Institute that found that annual retail prices for more than 100 top brand name medications used by chronic sufferers have, on average, more than tripled in cost since 2006. A medicine that cost $100 in 2006 now costs more than $300; a $400 medicine is now more than $1,200. To be clear, we’re talking about the same medicines, just at more than three times the cost.

Meanwhile, people are suffering – some more than others to be sure – but few escape the deleterious effects of out-of-control drug prices. Last year, the average senior taking brand name drugs to treat chronic conditions faced more than $30,000 in drug costs. Sure, insurance (depending on the kind you have) covers some of that, but with 7.1 million older adults in the US living in poverty, too often older people face the grim reality of having to choose between paying for their medicines and paying for food or rent.

And if the last decade is anything to go on, what will these medicines cost a dozen or so years from now? Six times their current prices? If past is prologue, that’s where we’re headed.

So, what can be done?

Allow Medicare to negotiate on what it pays for prescription drugs

Currently, Medicare cannot negotiate prescription drug prices with pharmaceutical companies. That’s right, for some medicines, drug makers name their price and taxpayers pay it – no questions asked. The time is now to enable the Health and Human Services Secretary to use the bargaining power of Medicare’s more than 55 million beneficiaries to negotiate for lower prescription drug prices.

Prohibit anti-competitive practices

Brand name drug makers hate losing customers when another manufacturer is able to bring to market a generic drug that does the same thing for a lower cost, and there are lots of ways they try to reduce the competition. One of them is to pay the generic drug maker to delay bringing the drug to market for an agreed-upon time, usually measured in years.

Another is to refuse to sell generic drug makers the samples of brand drugs that they need to conduct tests in order to demonstrate to Food and Drug Administration regulators that a generic is as effective as the brand name drug.

So much for competition. Congress should act to stop these kinds of abuses that delay the availability of less-expensive generic drugs, costing the US billions of dollars.

Lower out-of-pocket costs

The combination of limited income and rising drug costs means many older Americans are struggling to afford the high out-of-pocket costs for expensive prescription drugs. Medicare Part D, which covers pharmacy costs, has an out-of-pocket limit of $5,100. But beneficiaries are still responsible for some costs even after they reach catastrophic coverage (which begins once you hit your out-of-pocket limit). And Medicare Part B, which covers doctors’ treatments, does not limit out-of-pocket costs at all. The bottom line is that too many older people struggle financially just trying to maintain their health. It’s time to lower or cap out-of-pocket costs.

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    To be sure, none of these things on their own, or even in concert, will solve the problem of ever-skyrocketing prescription drug costs. There’s also work to be done around importation, drug pricing transparency and more. But there’s a lot that can – and should – be done now.

    A lot of it is common sense, and the only parties who seek to obscure that are those with a vested interest in keeping things the way they are.

    The Senate Finance Committee hearing on runaway prescription drug costs was a good start, but it’s just that: a start. To provide citizens with drugs they can afford, we must take steps to limit the power of big pharma.