IN SUMMARY: A study, in the journal JAMA Network Open, found a substantial industry-wide rise in insurer and out-of-pocket costs for top-selling, brand-name prescription drugs, highlighting one of the foremost problems in health care today: unimpeded price increases in the pharmaceutical market. Pharma companies are daring the government to intervene in the drug pricing debate.
In the study, researchers from the Scripps Research Translational Institute analyzed Blue Cross Blue Shield pharmacy claims from 2012 to 2017, focusing on a total of 49 brand-name drugs that had more than 100,000 total claims each.
All but one of the drugs included in the study saw regular annual or biannual cost increases. The cost of 36 of the drugs increased over the six-year period by more than 50 percent, and the cost of 16 more than doubled. Overall, the median cost of the drugs included in the study increased 76 percent.
Insulin drugs such as Novolog, Humalog and Lantus and rheumatology drugs such as Humira and Enbrel had some of the largest increases in costs. The price of Humira, for example, rose from $1,940 in January 2012, to $4,338 by December 2017.
The conclusion
Seniors now pay more out of pocket for cancer drugs than they did in 2010
The Affordable Care Act reduced seniors’ share of their drug bills, but price increases — on new and old drugs alike — have canceled out those savings. Many cancer drugs aren’t covered by Medicare Part D. They are instead in Part B, because they’re administered by a doctor rather than picked up at a pharmacy.
- For example, out-of-pocket spending on Revlimid increased, on average, by more than $4,000 between 2010 and 2018.
The drug companies continue to push the envelope for and pricing intervention is just a matter of time. It seems that they want to take the money now, while they still can and don’t care that patients are having a hard time with costs. It’s more proof that it’s about profits not patients.