For the first time ever, most employers believe that spending on pharmaceuticals — specialty drugs, in particular — is the primary driver of the nation’s rapidly spiking health care costs.
The National Business Group on Health published its survey results earlier this month, and the people polled are far from the only ones showcasing the concern.
“People are more likely to see a price hike in life-saving drugs or drugs for very rare diseases,” said one pharmacist.
“Costs for prescription drugs continue to increase and are anticipated to again outpace the costs for other medical services,” the American Academy of Actuaries said on its website, referring to the major drivers of 2017 premium changes.
“More high-cost specialty drugs are expected to come to market (e.g., new drugs to treat cancer). Some drugs (e.g., Crestor, Benicar, Symbicort) are coming or have recently come off-patent and will over time reduce drug costs,” the AAA said. “However, price decreases aren’t necessarily immediate because generic competition for drugs coming off-patent is often limited or slow to be adopted.”
Patients, physicians, and lawmakers aren’t waiting for costs to come down or for someone to explain, especially where life-saving drugs are concerned. Two senior lawmakers on the U.S. Senate’s Judiciary Committee are pushing for information on the steep price increases for EpiPens, the drug-filled injectable devices used to counter potentially deadly allergic reactions.
The top Democrat on the committee’s antitrust subcommittee, Sen. Amy Klobuchar of Minnesota, is calling for an investigation, citing news reports showing that the price of a pack of two EpiPens has gone from $100 in 2008 to $500 this year, as Reuters reported.
For every medication that gets approved, at least 20 others fail to move forward.
Another report this week in JAMA shows promising new cholesterol-lowering drugs are priced at $14,000 a year per person. The pharmaceuticals could add $120 billion annually to the nation’s health care costs if taken by all eligible patients, USA Today reported.
The authors of the analysis said they hope the estimate starts “a national conversation about drug prices, the value of new medications, and how much Americans are willing to pay to improve health.”
“It’s an unfortunate turn of events that life-saving drug prices continue to skyrocket,” said Mohamed Jalloh, a spokesman for the American Pharmacists Association (APhA).
“Pharmaceutical companies are able to change the price of their medications at their discretion. A key example was the infamous Martin Shkreli, who hiked the price of each tablet of the drug, Darapim, from around $13 to over $700. While this is an extreme example, it validates [the point] that pharmaceutical companies have the ability to change the price of their medications,” he told LifeZette.
People are more likely to see a price hike in life-saving drugs or drugs for very rare diseases, added Jalloh. Keep in mind, he said, that pharmaceutical companies spend billions of dollars on research, development, and marketing medications.
“Pharmaceutical companies have to price the medications accordingly to ensure they make a profit to allow the further development of new medications. Another interesting thing to note is that for every medication that gets approved, at least 20 others have failed to receive approval. This means pharmaceutical companies would still have to pay for all of the costs of developing a medication despite it not receiving ultimate approval.”
So how do you protect yourself, your family, your health, and your pocketbook at a time when it seems pharmaceutical companies are looking out only for themselves?
Talk with your pharmacist, said Joseph Sanginiti, president and COO of FamilyWize, which offers a prescription assistance program through a free prescription savings card and app.
“Use your pharmacist as a resource, not only for important information on your medications, but also on how best to save on the costs of those medications. Ask about generic options, discount opportunities, and if all the meds you are prescribed should be taken together,” he said.
Some other best practices when trying to save on prescriptions, according to Sanginiti and Jalloh:
1.) Opt for generic drugs over brand name. Generic drugs have the same ingredients, dosage, intended use, side effects, and strength as the original drug.
2.) Consider a program like FamilyWize, which offers free enrollment and no hidden costs, and doesn’t bar anyone with pre-existing conditions. This program and other pools receive competitive pricing on prescriptions, which is passed directly on to customers.
3.) If your insurance company doesn’t cover your medication, talk with your doctor or pharmacist about alternatives that are effective but cost less money.
4.) Comparison shop with your local pharmacies. GoodRx, LowestMed, and LowRx are mobile apps that are designed to show you the prices of medications at various pharmacies.
5.) DO NOT alter your daily dosage to try to make your prescription medications last longer. This is extremely dangerous and can cause severe side effects or additional medical issues. Always follow the instructions given by your doctor.
6.) If you have insurance through work, consider getting a Flexible Spending Account (FSA), which can save as much as 30 percent yearly on out-of-pocket medical expenses.