Rising drug prices are one of the top three health care challenges we face today. Considering that President Donald Trump and state elected leaders in California and across the country have voiced concern over this growing problem, it is baffling that the issue was absent from policy discussions during the Congressional “repeal and replace” effort.
No country spends as much per capita on health care as the United States. Health care spending in the U.S. is more than twice the average of all other developed nations. One of the major contributors is the rising cost of prescription drugs, which today accounts for roughly 17 percent of all U.S. health care spending.
The “repeal and replace” effort simply ignored what is a growing nonpartisan crisis: the impact of rising prescription drug prices on working men and women. This is a pure pocketbook issue. Costs are stopping families from filling or refilling medications.
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Some argue that importing prescriptions from Canada, where prices are lower, could solve this problem. But this solution is not without risks. There’s no way to certify the efficacy of prescription medications being shipped from Canada, or anywhere else.
Other attempts to make prescriptions more affordable have been piecemeal at best. For example, pharmaceutical companies offer assistance through two vehicles – Patience Assistance Programs and co-pay cards – designed to increase access to medications for those who cannot afford them. But these programs are not widely marketed and some elected officials have shortsightedly sought to eliminate them altogether.
Patient Assistance Programs were created by pharmaceutical companies to help the uninsured access needed medications at no charge or for a small co-pay; they have grown to include many whose insurance fails to adequately cover expensive medication for chronic diseases. The goal of these programs is to ensure that Americans don’t have to choose between buying food and filling prescriptions, or live with the fear that their illness may lead to bankruptcy.
For people who have insurance but an inadequate prescription plan, co-pay cards can be used to lower costs by reducing or eliminating out-of-pocket costs. A co-pay is the fixed amount that insurance companies ask consumers to pay toward their medication or other health services. They often reduce the level of co-pay or cover the cost entirely.
Poor people have access to free or almost-free medications from Medi-Cal. Yet some elected officials want to legislate whether and how middle class families can access Patient Assistance Programs and co-pay cards.
In the absence of a more comprehensive effort to improve health care and lower costs, elected officials should at least work with pharmaceutical companies to ensure their constituents know about the availability of these free and/or subsidized programs.
Programs that help working families access critical medications should have the support of every elected official. Both public and private sector employees can benefit, as can employers who will reap the savings from having healthier employees who are better able to manage their chronic illnesses. This may include CALPERS and CALSTRS. Everyone wins.
It is long past time that pharmaceutical companies launch a statewide effort in California to educate every resident about Patient Assistance Programs, co-pay cards and other low-cost solutions to the high cost of prescription drugs. This one bold step could save working families hundreds or thousands of dollars.
The need is great. We cannot wait for Congress.
But, will the pharmaceutical industry stand up and help?
Jeffrey Lewis is the president and CEO of Legacy Health Endowment and can be contacted at firstname.lastname@example.org. The views expressed are his own.