When Virginia patients walk into local pharmacies to fill a prescription, they hope they’re on a path to healing — not more pain.
Weeks later, a bill arrives in the mail. The reality sets in. The medicine is too expensive.
A September AARP fact sheet captured a recent snapshot of how skyrocketing prescription drug costs are affecting health care in the commonwealth and across the country. In 2017, 23% of Virginians ages 19-64 said prices forced them to stop taking their medications. The analysis came from the State Health Access Data Assistance Center, a Robert Wood Johnson Foundation initiative at the University of Minnesota. The data came from the National Health Interview Survey, conducted by the Centers for Disease Control and Prevention (CDC).
AARP’s Rx Price Watch reports shed some light on why Americans are struggling to stay on their prescriptions. Over the past few years, some patients experienced severe sticker shock. For example, Lantus, which targets diabetes, went from $2,907 per year in 2012 to $4,702 per year in 2017. Aggrenox, which addresses heart disease, increased from $3,030 a year to $5,930 a year over that same span.
Drugs for more serious conditions like cancer can carry price hikes above an annual salary. Revlimid, which treats certain types of cancer, ballooned from $147,413 per year in 2012 to $247,496 per year in 2017. Unsustainable is the first word that comes to mind.
That’s why we’re pleased to see U.S. Rep. Abigail Spanberger, D-7th, and AARP Virginia State Director Jim Dau hold important conversations like Tuesday’s prescription drug town hall in Glen Allen. Community input matters on lowering costs and the public knows the issues that require legislative attention from Congress.
Market transparency would be a good start. In late October, the House unanimously passed Spanberger’s Public Disclosure of Drug Discounts Act — a bill requiring the Centers for Medicare & Medicaid Services to post information online about how pharmacy benefit managers (PBMs) negotiate with manufacturers and charge consumers.
According to the journal Health Affairs, PBMs raked in an estimated $22.6 billion in gross profits in 2016. The National Academy for State Health Policy also notes the three largest ones — Express Scripts, CVS Caremark and Optum Rx — hold great power, controlling three-quarters of the market.