Are prescription drug prices really that high?
Thursday, November 02, 2017
I was recently asked to participate in a health fair, representing retail pharmacy, to provide information and advice for dealing with the high cost of prescription drugs.
As patients poured into the event, they browsed past scores of tables and vendors who were advertising their products and services. There were CPR demonstrations and blood pressure checks and nutritional services and addiction information.
It was a wonderful event. I'm pleased to have participated and hopeful that helpful information was shared.
But it was also a good reality check on the true public perception surrounding drug prices. "My copays are all pretty low," said one visitor. "I get my medicine in the mail. I don't like doing that, but it is affordable," said another.
One nicely dressed patient said, "Yes, prices can be a problem. I once had to pay $9 for a month's supply of my cholesterol medication. But now I get it for $3, which is much better." Note, this was said while she sipped on a $5 Starbucks coffee.
In fact, it could be argued that prescription prices are so low the public generally expects to get them for almost nothing. The other day I had a doctor bring in a couple of prescriptions for his wife. The copay total was $10 for one of them and $4.57 for another.
"I'll take the prescriptions back," he said. "I can get them for $3 each at my hospital."
All around the country politicians are talking about the problem of skyrocketing drug prices and unaffordable medication. And all across America patients are picking up the vast majority of their prescriptions for less than it costs for a cheeseburger and fries.
As I sat at my booth and tried to find a single patient to share stories about their plight with high prices, I found myself feeling like a vegetarian at a meat raffle. I had nothing to do.
And my boots-on-the-ground observations as a pharmacist seem to be confirmed by what is going on in big pharma and the insurance industry as well. We all remember being shocked several years ago when a blockbuster drug for curing Hepatitis C entered the market and payers had to cough up $84,000 or more to cure patients. People complained such pricing was simply unsustainable.
But then what always happens in pharmacy happened again. A competitor hit the market with a new, lower $54,000 price tag. And now, several years later, prices have fallen for even newer treatments to nearly $25,000 for eight weeks.
And PBMs aren't suffering from high drug prices either. In a recently released article by Adam Fein of Drug Channels, Prime Therapeutics (the fifth-largest PBM) has shown virtually no growth in spending for 2017.
"The data demonstrates that public perception of outrageous drug spending growth has not caught up with 2017's realities," he wrote.
And this has been the experience across other payer types as well.
"Medicaid and Medicare Part D saw year-over-year declines in drug spending due to lower drug costs but slightly higher utilization," Fein wrote.
Now, I'm not suggesting that there aren't expensive drugs out there. And I'm not suggesting every patient finds their medication affordable. They don't.
Nothing is more frustrating to a pharmacist than seeing patients who have worked their whole life having to make hard choices between buying prescriptions and buying food. There are still too many patients that are the exception to this rule and cannot afford their medicine. This shouldn't be happening, and we can do more as a nation to prevent this.
However, the oft-repeated rhetoric that we are drowning as a nation in high drug prices is simply out of touch with the experience of many real-life patients. We have a lot of things to fix in our country, but this is not one of them.
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