Drug prices out of control?

KEY TAKEAWAY:  A new survey from Consumer Reports Best Buy Drugs shows that twenty-five percent of Americans who regularly take a prescription drug say they now pay more out of pocket than they did 12 months ago for at least one of those medications.  It’s just a matter of time before Congress takes action, but is the drug industry ready?

CR’s survey shows that some of the price increases are substantial. Twenty-four percent of regular prescription takers who said they payed more out-of-pocket shelled out $50 or more for a single prescription this year than they did for the same prescription a year ago.[inlinetweet prefix=”” tweeter=”” suffix=””] Nearly half of regular prescription takers who now pay more out of pocket (47%) said that, year over year, they paid an additional $20 or more for a drug they regularly take[/inlinetweet]. Fifteen percent paid $100 more this year for one of their scripts than they did for the same one in 2016.

[inlinetweet prefix=”” tweeter=”” suffix=””]Just because a person is insured, it doesn’t mean he or she can actually afford their doctor[/inlinetweet], hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchanges, that figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.

Are Drugmakers deaf?

[inlinetweet prefix=”” tweeter=”” suffix=””]The launch prices for drugs introduced from 2012 to 2016 were double the launch prices for those introduced prior to 2012[/inlinetweet], among the top 200 brand name drugs by 2016 sales. And while rebates for the second drug introduced into a competitive class are higher than the first drug’s rebate 72 percent of the time, the chance of the second drug having a higher launch price than the first drug is only 50 percent.

Drugmakers’ pricing strategies are also not connected to the rebates and discounts they negotiate with pharmacy benefit managers, according to a new analysis from the Pharmaceutical Care Management Association. The study found that prices rise even when rebates are low, or non-existent.

Consumers feel the pain.  Modest raises are often negated by the increased costs of health insurance and prescription drugs.  You can bet that this becomes a bigger issue Congress is going to listen to the cries of voters and act.