Securing an Affordable Healthcare Future for Patients

The drug pricing debate in Washington has kicked into high gear, and it’s more contentious, convoluted, and misguided than ever. Who is on which team? Whose “turn” is next? And, more importantly, what is in the best interests of patients and taxpayers? These questions may sound rhetorical, but they are questions Congress should be asking.

Here’s why: Navigating complex and divergent drug pricing proposals can be tricky, but the formula for determining what should get a “yes” or “no” vote should be fairly straightforward. First: Support bills that will reduce drug prices and make prescription drugs and health benefits more affordable for patients. Second: Oppose bills that would limit options and increase costs for patients, employers and taxpayers.

The reality is that solutions to the current challenge of prescription drug affordability in this country can also be simple. But that is certainly not the case – mainly because we are currently in an environment where the pharmaceutical industry lobby is deliberately trying to cover its tracks and advocate for legislation that does nothing but create loopholes in the law that could harm the profitability of their own businesses.

We have to go back to basics and, first and foremost, recognize that the big pharmaceutical companies set the prices of the products they manufacture and sell. And some big pharma works incredibly hard to protect their pricing power and brand monopolies – so market competition doesn’t force them to lower prices. Lawmakers can’t make a dent in the problem if they don’t understand – or choose not to recognize – who has full decision-making power over the price of a pharmaceutical product.

Look no further for proof that recent announcements from pharmaceutical companies to reduce their list prices on insulins. Companies have simply chosen to lower their prices, regardless of discounts or anything else. It can be done and should be done.

It remains to be seen whether the insulin price cuts are the start of a new trend of drug companies cutting list prices. The insulin price cuts were clearly the result of public scrutiny – people demanded action from insulin manufacturers, and they acted. And it’s a good thing. We should praise him and ask for more. But it’s far from clear whether other drug companies will follow – especially when many have been so successful in convincing lawmakers and the American public that they are somehow not responsible for the list prices of the products they only manufacture and sell.

So what else can be done to reduce costs?

Congress can start by preserving and strengthening the parts of the private market system that work to reduce costs and provide choices for employers and other plan sponsors to provide affordable health care coverage. Government data has proven time and time again that drug benefit companies reduce prescription drug costs and in fact pass on nearly all of the savings, saving payers and patients an average of $1,040 per person per year.

Congress should reject the false narrative that somehow pushing rebates and rebates for employers and patients has to do with the prices set by pharmaceutical companies. And, given the abuses of pricing and patent power we’ve seen from Big Pharma, Congress should also reject legislation that ties the hands of only entities providing price control to pharmaceutical companies.

Rather than limiting employer choice and narrowing options for cost savings, Congress should call on drug companies to continue lowering list prices and enacting laws that increase competition in the marketplace. In most industries, but especially in the prescription drug market, competition is the most effective way to reduce costs for the consumer.

A set of bipartisan laws has just been unanimously introduced in the Senate that would encourage the kind of cost-cutting competition that our healthcare system desperately needs right now. The legislation takes a holistic view of the prescription drug supply chain, rather than isolating one aspect of it, and, more importantly, ends the common and flagrant abuse of the pharmaceutical patent system as a means of providing options more affordable prescription drugs for patients. .

In a recent Senate Finance hearing on drug benefit corporations, it was noted that more than 3 out of 4 patents granted for prescription drugs are for existing, i.e. already patented, drugs. For the ten top-selling drugs in the United States, there are an average of 74 granted patents, preventing generics and biosimilars from entering the market. Patent thickets on five of the ten top-selling drugs in the United States have resulted in more than $500 billion in additional sales for drug companies. And patent abuse blocking biosimilars from the market alone will cost patients an estimated $30 billion over the next decade – on top of a $5 billion price increase due to the loss of competition from biosimilars. biosimilars between 2015 and 2020.

The patent abuse bills include strong, easy-to-implement legislation that will reduce costs for consumers and taxpayers. Unfortunately, they don’t make headlines or get the traction they deserve. Instead, big pharma uses big budgets for advertising, lobbying, and third-party sponsorship to ensure that congressional and media attention remains focused on drug benefit companies and the convoluted ways of serving them. legislate – efforts that limit the ability to push for price concessions on prescription drugs and deprive employers of choice about the benefits they provide to their own employees.

So, at the next drug price hearing or markup, don’t just ask: Who’s next? Ask instead: What will really reduce drug costs? The answers – and there are answers – should be patient-driven, not profit-driven, especially in an environment like the one we find ourselves in today, where the drive to reduce prescription drug costs for patients is stronger than ever on both sides.

Pharmacy benefit companies share this determination – and a deep sense of responsibility to be part of the solution for patients who struggle to pay for and access their medications. That’s why our industry has released a policy platform, “Unlocking an Affordable Future”, outlining a new vision for a more accessible and affordable healthcare future – one focused specifically on how to build on what works in our health care system while moving towards a more functional, equitable and affordable market for patients to have access to prescription drugs.

Building an affordable and sustainable healthcare future that puts value for patients first requires collaboration and accountability from every entity in the prescription drug supply chain. Pharmacy benefit companies are ready to work with policymakers and private and public sector partners to do their part and invite others to join us in advancing tangible, patient-centric solutions.

JC Scott is President and CEO of the Pharmaceutical Care Management Association (PCMA).