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Making Sure Patients Can Afford Their Medicines

The United States is in an exciting new era of medical discovery that holds unlimited promise for potential medicines targeting complex conditions. America’s biopharmaceutical companies continue to invest in and create treatments that transform the lives of patients, building on recent advances that fundamentally altered the way we understand and fight life-threatening conditions such as hepatitis C, various cancers and rare diseases. 

 

Even with this wealth of innovation, spending on brand medicines is growing at the slowest rate in years due to robust negotiation and competition in the marketplace. In fact, after factoring in discounts and savings, prices for brand medicines increased just 0.3% last year and total spending on retail medicines increased just 4.5%in 2018. 

 

Despite this slowed spending growth, more Americans are struggling to afford their medicines. Unfortunately, patients today do not benefit from the savings generated from price negotiations among biopharmaceutical manufacturers and other payers. These savings and discounts exceeded $166 billion in 2018 alone and are growing every year – but patients often don’t see these financial benefits at the pharmacy counter. Our health care system is not working for patients and it needs to change. 

 

Today, policymakers in Washington are debating changes that could limit people’s ability to access life-saving treatments. Instead of setting up new barriers, we must encourage approaches that improve patient access and affordability 

 

We must continue to support patient-focused policies that allow individuals to benefit directly from negotiated discounts on their medicines. These saving could save patients hundreds of dollars each year and help promote consistent, appropriate use of medicines. One approach would help fix misaligned incentives in the system and ensure insurers and middlemen share savings directly with seniors at the pharmacy counter.  Under this approach a Medicare patient with diabetes taking five medicines, including insulin, could save nearly $900 a year.

 

Patients in the commercial market would also benefit from receiving access to discounted prices at the point of sale. Depending on factors like plan design and medical out-of-pocket spend, some patients may see their annual out-of-pocket spending reduced. Other patients would pay less each month and could have their costs spread throughout the year, so it would take longer to hit their out-of-pocket maximum and resulting in lower monthly costs. For example, a patient with diabetes along with several other health conditions enrolled in a high-deductible health plan with coinsurance that spends $5,000 annually out of pocket on his medical and pharmacy expenses could save about $800 annually if negotiated discounts were shared.

 

Patients share the costs. They should share the savings. Learn more at LetsTalkAboutCost.org.