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(Evan Mintz, graduate of Cardozo School of Law, Director, Executive Communications of Arnold Ventures, 10/06/2023, “How a Broken Patent System Contributes to Unaffordable Prescription Drugs”, Arnold Ventures, , accessed 06/27/2024) Cinj - WH

If you invent and successfully patent a product in the United States, it is typically protected from competition for 20 years. This intellectual property system, which is established , is intended to ​“promote the progress of science and useful arts” by rewarding innovation with a government-granted monopoly for a set period of time.

(Matt Sandgren, Capitol Hill Veteran specializing in Government Affairs, Public policy, and Strategic Consulting, from the George Washington University Law School, 02/21/2024, “For cheap generic drug prices, you can thank 40 years of Hatch-Waxman,” Washington Examiner, , DA: 06/30/2024) da-wh

Here’s another item for that list: generic drugs. Today, when you fill a prescription, odds are it’s with a generic. In 2021, the Food and Drug Administration reported that of all prescriptions filled in the United States were filled with generics. 

Gothe, H., Schall, I., Saverno, K. et al. The Impact of Generic Substitution on Health and Economic Outcomes: A Systematic Review. Appl Health Econ Health Policy 13 (Suppl 1), 21–33 (2015). Access on 6/30/24 Through KU Library, Berto – WH

*GS – Generic Substitution

Taylor Herzlich, Taylor Herzlich is a business reporter at the New York post and graduated Fordham university with degrees in journalism and English, 28 June 2024, “Drug Prices Soar Nearly 40% over Past Decade, Surpassing Inflation, Study Shows.” New York Post, nypost.com/2024/06/28/business/drug-prices-soar-37-in-past-decade-surpassing-inflation-study/. Accessed 30 June 2024. ES – HW

The cost of prescription drugs in the US has soared nearly 40% over the past decade, surpassing the rate of inflation during the same span, according to a new study.

Susan Jaffe, Susan Jaffe is a health news writer on health policy, and Lancet’s DC correspondent. 11 June 2024, “Biden’s Plan to Save Money on Medicare Drugs Risks Leaving Shelves Empty, Pharmacists Say.” Fortune, fortune.com/2024/06/11/biden-drug-prices-pharmacy-losing-money/. Accessed 30 June 2024. ES - HW

Months into a new Biden administration policy intended to lower drug costs for Medicare patients, independent pharmacists say they’re struggling to afford to keep some prescription drugs in stock.

Hazel and Sophia,11-14-2024, “PAYING THE PRICE: HOW DRUG MANUFACTURERS’ GREED IS MAKING HEALTH CARE LESS AFFORDABLE FOR ALL OF US” FamiliesUsa, https://familiesusa.org/resources/paying-the-price-how-drug-manufacturers-greed-is-making-health-care-less-affordable-for-all-of-us/

Families across America are facing a health care affordability crisis. In 2021, the United States spent $4.3 trillion on health care, two or three times more per person than other wealthy countries. Yet the U.S. still has some of the worst health outcomes and health care quality.1,2 Furthermore, high and rising health care costs force millions of people to choose between the health care they need and basic necessities.3 One-third of Americans say that the cost of medical care interferes with their ability to have food and housing.4 And, these high and rising costs drive more than 40% of adults into medical debt, further exacerbating their health and financial struggles.5 The high costs of prescription drugs are particularly egregious and play a big part in the affordability crisis. Over the past 15 years, launch prices — the initial prices of drugs set by manufacturers — grew more than 20% each year.6 In 2021 alone, the U.S. health care system spent $603 billion on prescription drugs (before rebates), and national prescription drug expenditures grew faster than spending on both hospital services, and physician and clinical services.7,8 Even after drugs launch, their prices continue to rise at irrationally high rates. For example, the price of Victoza (a popular diabetes and weight loss medication launched in 2010) increased a staggering 42% in just five years, rising from $7,936 per year in 2015 to $11,300 per year in 2020.9 The impact of these high prescription drug costs on individuals and families who rely on these medications is clear, with almost 30% of adults not taking their medications as prescribed in the past year — rationing their medications, skipping doses, or not filling their prescriptions at all.10,11,12 Being forced to make those decisions directly results in poorer health outcomes: rationing or skipping needed medication causes an estimated 125,000 deaths a year.13,14 What many Americans might not know is that not only do high and rising drug prices drive up health care costs for people at the pharmacy counter, but they also drive up health care premiums and deductibles and are often experienced in the form of reduced wages.15,16,17 For example, if a person with insurance from their employer is charged a very high price for a prescription drug, not only will those individuals receiving the drug have higher cost sharing, but also that high price will be factored in when establishing future premium costs for all employees insured in the employer’s insurance pool. This means we all end up paying the price for drug manufacturers’ greed, whether or not we take a prescription drug. For the 60% of U.S. adults currently taking at least one prescription drug and the 25% taking four or more, this means paying for prescription drugs multiple times, including through monthly premium payments, payments to reach their deductibles, and any out-of-pocket expenses paid at the pharmacy counter.18 Drug companies make the system work for them, not people who need care The entire business model of big drug companies is rooted in abusing their monopolistic or quasi-monopolistic position, including price gouging, protecting drug exclusivity through anticompetitive behavior, and increasing profits on old drugs rather than investing in new and innovative treatments to help our nation’s families.19 Simply put, it is a business model that is often rooted in greed. Just this year, a Stanford University business and medical school professor wrote in Forbes, “In the 21st century, most drug companies have replaced moonshots with chip shots: strategies aimed at minimizing risk. Rather than chasing the elusive game-changing drug, today’s biopharma giants focus on monetizing easy wins.”20 Drug companies game the prescription drug market and health care system from beginning to end. When drug companies file patents to bring new drugs to market, they can receive “exclusivity” on those drugs during which time no other company can market a competing drug.21,22 In general, under a series of federal laws, most prescription drugs receive between 12 to 16 years of exclusivity and patent protection to reward innovation, with the average being about 14.5 years.23 This length of time is in part the result of drug companies learning how to abuse this privilege, turning exclusivity and patent protections into a perverse incentive to maintain exclusivity as long as possible in order to maximize profits off old drugs without expending additional resources to develop new ones.24 Drug companies regularly deploy a barrage of tactics to extend their exclusivity periods, keep generics off the market, and maintain their market dominance.25 Common examples include blanketing one drug with multiple and overlapping patents to create a “patent thicket” and paying potential competitors not to produce a generic drug as part of a “pay-for-delay” scheme. In fact, the 10 top-selling drugs on the market today have been granted an average of 74 patents per drug, with an average of 140 patents filed for each of them.26 Importantly, 66% of those patent applications are filed after the drug is approved by the Food and Drug Administration.27 This means that drug manufacturers file new patents, looking to extend drug exclusivity periods, to protect against generic competition with no significant changes made to the original drug itself. Drug companies have an overwhelming financial interest in having market and patent exclusivity that has no relation to improvements to the medications or accessibility of the medications for patients.28,29 When Revlimid, a chemotherapy drug, had patent exclusivity, it brought in $23.8 million per day in revenue. When Keytruda, a cancer drug, had exclusivity it made $26.8 million per day in revenue. And before its first competition came onto the market in early 2023, Humira, an immunosuppressant drug treating arthritis and Crohn’s disease, made $47.5 million per day in revenue for its manufacturer.30 Finally, once they have established market dominance, drug companies can price gouge freely, raising prices year after year at shocking rates on the medications that they have long since released. These price increases are wholly unrelated to the effectiveness of a drug over time. One study of high-spend drugs showed that seven of the 10 drugs reviewed provided no additional clinical benefit relative to other available drugs to justify their high list price or price hikes.31 Some examples of price gouging are particularly predatory. For instance, the drug manufacturer Mylan faced and settled a series of class-action lawsuits resulting from its widely publicized price increases of more than 400% for the EpiPen.32 In another example, even though the FDA first approved the use of naloxone to treat opioid overdose in 1971, the company manufacturing the drug raised the price from $1 to $150 for a two-pack of nasal spray in the mid-2010’s and charged $4,500 for an auto-injected version of the drug — putting it out of reach for people who needed it.33,34,35 Since then, opioid overdose deaths in the U.S. continued to rise each year, reaching 80,411 deaths in 2021.36 Time and time again, drug companies demonstrate that it is easier and more profitable for them to abuse patent law, limit competition, and raise prices rather than investing in new, innovative treatments that will help people live longer, healthier lives.37 High drug costs do not stop at the pharmacy counter Most people think of high drug costs as a problem when they are filling a prescription. But that is only part of the story. As drug companies continue to price gouge and drug prices go up, consumers are stuck with the bill in more ways than one. That is because drug companies set the list price for their drugs long before they are purchased by the consumer. These underlying prices are paid by insurance providers who in turn pass those high and rising costs along to families and employers in the form of higher insurance premiums. The problem of costs being pushed onto the consumer is particularly pronounced for the 174 million people with employer-sponsored insurance (ESI), because the premium and deductible structure in these private plans are particularly vulnerable to drug pricing increases as compared to the more standardized structure of Medicare or Medicaid.38,39,40 The increased prices charged by drug companies for their drugs become part of the costs analyzed by actuaries to establish updated health insurance premiums, and those increased premiums accrue to all people within an insurance pool, regardless of whether those enrollees take prescription drugs. Put simply, when a drug company abusively increases its prices, the amount insurance companies pay increases, and insurance premiums increase right along with them, for everyone, whether or not they take prescription drugs.41,42 In fact, almost 20% of health insurance premiums are driven by the rising cost of prescription drugs.43 These premium increases result in a cascade of negative impacts on health care affordability for employers and workers alike. In the past decade, health insurance premiums for those with private insurance rose faster than the rate of inflation and workers’ wages.44 From 2012 to 2022, the average premium for family coverage rose 42%, from $15,745 a year to $22,463 a year, and the average premium for an individual rose 40%, from $5,615 a year to $7,911 a year.45 In 2022, health insurance accounted for almost 8% of employee compensation, second only to wages and salary.46 As monthly premiums increase, wages rise more slowly because increased health care costs cause employers to spend more of their annual budgets on employee health care and less on employees’ take home pay.47 This problem is especially concerning for individuals who are already paid low wages and are then forced to contribute a disproportionately high percentage of their wages toward health insurance premiums.48 On top of increased health insurance premiums, high drug prices result in other increased health insurance-related costs in the form of deductibles, coinsurance, and copays — for prescription drugs and other health services alike. With 50% of out-of-pocket spending on medical care (including prescription drugs) experienced through deductibles, increasing deductibles leaves consumers paying more out-ofpocket and exposes more consumers to the full price of their prescription drugs and other health care services.49,50 In 2019, a Consumer Reports survey revealed that 30% of adults who take a prescription drug regularly experienced out-of-pocket cost increases from one year to the next, and 12% said those costs went up by $100 or more.51 The average deductible for covered workers in 2022 was $1,763 for single coverage, and just one year later, in 2023, that average had grown to $2,004.52,53 Increases to deductibles and premiums affect all people with health insurance, regardless of what kinds of care they are seeking, and when taken in combination with the stagnating effect on wages, it is clear that high and rising drugs costs are compounding families’ financial insecurity.54,55

Nicole Rapfogel, Nicole Rapfogel is a policy analyst for Health at American Progress. Prior to joining American Progress, she interned with the Field and Outreach team at Population Connection, where she organized and advocated for U.S. policy to advance global reproductive health and rights. She graduated magna cum laude from Duke University with a bachelor’s degree in public policy and global health and completed her Master of Public Health at the Geisel School of Medicine at Dartmouth College, NOV 1, 2023 “Drug Companies Continue To Hike Prices Above Inflation.” Center for American Progress, www.americanprogress.org/article/drug-companies-continue-to-hike-prices-above-inflation/. Accessed 30 June 2024 – emron---wh

To assess the scope of drug price increases above the inflation rate in the commercial market, CAP analyzed a dataset provided by Patients for Affordable Drugs of all drugs with list prices that increased more than 1 percent on July 1, 2023. These price changes represent one of two times drug companies typically adjust their prices in a given year: January 1 and July 1. The analysis used the 3 percent Consumer Price Index for All Urban Consumers (CPI-U) for June 2022 to June 2023 as the inflation rate against which to compare price hikes, aggregating all dosage forms and strengths of each drug by taking the median price increase across all variations of a drug produced by a single manufacturer.

For far too long, drug companies have been free to both set prices as high as the market will bear and raise these prices year after year. In fact, according to a 2023 analysis by AARP, the 25 drugs with the highest aggregate Medicare spending have more than tripled in list price since entering the market. With 1 in 3 U.S. adults unable to afford taking their medication as prescribed, high and rising drug prices are having devastating impacts on Americans’ health and wallets.

To combat excessive pharmaceutical price hikes, the Inflation Reduction Act required drug companies to limit their Medicare price increases to the inflation rate or pay rebates, enabled Medicare to negotiate lower drug prices, and capped out-of-pocket spending for Medicare beneficiaries. However, while the law makes substantial strides toward lowering drug prices and improving access and affordability for people with Medicare, its provisions do not extend beyond Medicare to the commercial market, which covered nearly 55 percent of all Americans in 2021 and where excessive price hikes are also a significant concern.

Drug prices in the US increased 4.4% annually and median out-of-pocket (OOP) costs increased 9.6% annually from 2009 to 2018, but there was no direct link between these amounts for individual drugs.

Between 2009 and 2018, drug prices in the US increased at an annual rate of 4.4% while median out-of-pocket (OOP) costs increased 9.6% per year. However, researchers say there was no link between these increases for individual drugs.

Prescription drug spending in the US exceeded half a trillion dollars in 2020.1 Spending is driven by high-cost brand-name drugs, for which manufacturers freely set prices after approval.2 Rising brand-name drug prices often translate to payers restricting access, raising premiums, or imposing unaffordable out-of-pocket costs for patients. We evaluated recent trends in prices for newly marketed brand-name drugs.

Methods

Why does it matter if drug development is inherently unpredictable and not simply high risk?

The question strikes many in an industry with an end-to-end success rate of between 2% and 3% as (a) obvious and (b) irrelevant. Yet I would argue that the failure to distinguish between high and inherently unpredictable risk is a principal cause of pharma’s potentially catastrophic decline in productivity .

(Brian Dakss, writer for CBS News and editor/writer for NBC news, 08/06/2007, “Skipping Meds Courts Danger,” CBS News, , DA: 06/30/2024) jj-wh

But, the director of the federal Agency for Healthcare Research and Quality, Dr. Carolyn Clancy, told CBS News there's an irony there: Very often, people who don't take the amount prescribed cut the medicine's effectiveness in treating the condition. But side effects are generally just as potent for the lesser dose as for the proper dose. So, you're hurting yourself both ways: less effectiveness, and equal side effects.

(Rachel Murphy, journalist for Verywell Health and Health.com and CNET, 12/27/2022, “Prescription Drugs Costs Are Making Americans Sicker. Here’s How They’re Coping,” CNET, , DA: 06/29/2024) jj-wh

As basic expenses increase, soaring prescription drug prices are eating up an even larger portion of household income. Over just the last year, prescription drug prices rose at an average rate of 31.6%, with some increasing up to 500%, according to a recent Department of Health and Human Services government report. Americans, who pay the highest prices in the world for prescription drugs -- two to three times more than people in other countries -- are finding any way possible to get around the entangled pharmaceutical industry.

(Bharath Krishnamurthy, Master in Public Health at UVA and director, Health& Analytics at American Hospital Association, 05/22/2024, “Drug Prices and Shortages Jeopardize Patient Access to Quality Hospital Care,” American Hospital Association, ., DA: 06/29/2024) jj-wh

The high prices for drugs and shortages of many critical drugs like chemotherapy and IV saline bags also impact hospitals’ ability to provide a range of services to their communities, contributing to wider problems with access to care. Hospitals are major purchasers of drugs for use in patient care, and acquiring costly medicines and securing alternative therapies during a shortage are consuming a larger share of hospitals’ finite resources. As drug prices continue to rise, hospitals have fewer resources available to finance other parts of their operations, such as paying staff and purchasing other supplies needed for patient care.

Hazel and Sophia,11-14-2024, “PAYING THE PRICE: HOW DRUG MANUFACTURERS’ GREED IS MAKING HEALTH CARE LESS AFFORDABLE FOR ALL OF US” FamiliesUsa, https://familiesusa.org/resources/paying-the-price-how-drug-manufacturers-greed-is-making-health-care-less-affordable-for-all-of-us/

Families across America are facing a health care affordability crisis. In 2021, the United States spent $4.3 trillion on health care, two or three times more per person than other wealthy countries. Yet the U.S. still has some of the worst health outcomes and health care quality.1,2 Furthermore, high and rising health care costs force millions of people to choose between the health care they need and basic necessities.3 One-third of Americans say that the cost of medical care interferes with their ability to have food and housing.4 And, these high and rising costs drive more than 40% of adults into medical debt, further exacerbating their health and financial struggles.5 The high costs of prescription drugs are particularly egregious and play a big part in the affordability crisis. Over the past 15 years, launch prices — the initial prices of drugs set by manufacturers — grew more than 20% each year.6 In 2021 alone, the U.S. health care system spent $603 billion on prescription drugs (before rebates), and national prescription drug expenditures grew faster than spending on both hospital services, and physician and clinical services.7,8 Even after drugs launch, their prices continue to rise at irrationally high rates. For example, the price of Victoza (a popular diabetes and weight loss medication launched in 2010) increased a staggering 42% in just five years, rising from $7,936 per year in 2015 to $11,300 per year in 2020.9 The impact of these high prescription drug costs on individuals and families who rely on these medications is clear, with almost 30% of adults not taking their medications as prescribed in the past year — rationing their medications, skipping doses, or not filling their prescriptions at all.10,11,12 Being forced to make those decisions directly results in poorer health outcomes: rationing or skipping needed medication causes an estimated 125,000 deaths a year.13,14 What many Americans might not know is that not only do high and rising drug prices drive up health care costs for people at the pharmacy counter, but they also drive up health care premiums and deductibles and are often experienced in the form of reduced wages.15,16,17 For example, if a person with insurance from their employer is charged a very high price for a prescription drug, not only will those individuals receiving the drug have higher cost sharing, but also that high price will be factored in when establishing future premium costs for all employees insured in the employer’s insurance pool. This means we all end up paying the price for drug manufacturers’ greed, whether or not we take a prescription drug. For the 60% of U.S. adults currently taking at least one prescription drug and the 25% taking four or more, this means paying for prescription drugs multiple times, including through monthly premium payments, payments to reach their deductibles, and any out-of-pocket expenses paid at the pharmacy counter.18 Drug companies make the system work for them, not people who need care The entire business model of big drug companies is rooted in abusing their monopolistic or quasi-monopolistic position, including price gouging, protecting drug exclusivity through anticompetitive behavior, and increasing profits on old drugs rather than investing in new and innovative treatments to help our nation’s families.19 Simply put, it is a business model that is often rooted in greed. Just this year, a Stanford University business and medical school professor wrote in Forbes, “In the 21st century, most drug companies have replaced moonshots with chip shots: strategies aimed at minimizing risk. Rather than chasing the elusive game-changing drug, today’s biopharma giants focus on monetizing easy wins.”20 Drug companies game the prescription drug market and health care system from beginning to end. When drug companies file patents to bring new drugs to market, they can receive “exclusivity” on those drugs during which time no other company can market a competing drug.21,22 In general, under a series of federal laws, most prescription drugs receive between 12 to 16 years of exclusivity and patent protection to reward innovation, with the average being about 14.5 years.23 This length of time is in part the result of drug companies learning how to abuse this privilege, turning exclusivity and patent protections into a perverse incentive to maintain exclusivity as long as possible in order to maximize profits off old drugs without expending additional resources to develop new ones.24 Drug companies regularly deploy a barrage of tactics to extend their exclusivity periods, keep generics off the market, and maintain their market dominance.25 Common examples include blanketing one drug with multiple and overlapping patents to create a “patent thicket” and paying potential competitors not to produce a generic drug as part of a “pay-for-delay” scheme. In fact, the 10 top-selling drugs on the market today have been granted an average of 74 patents per drug, with an average of 140 patents filed for each of them.26 Importantly, 66% of those patent applications are filed after the drug is approved by the Food and Drug Administration.27 This means that drug manufacturers file new patents, looking to extend drug exclusivity periods, to protect against generic competition with no significant changes made to the original drug itself. Drug companies have an overwhelming financial interest in having market and patent exclusivity that has no relation to improvements to the medications or accessibility of the medications for patients.28,29 When Revlimid, a chemotherapy drug, had patent exclusivity, it brought in $23.8 million per day in revenue. When Keytruda, a cancer drug, had exclusivity it made $26.8 million per day in revenue. And before its first competition came onto the market in early 2023, Humira, an immunosuppressant drug treating arthritis and Crohn’s disease, made $47.5 million per day in revenue for its manufacturer.30 Finally, once they have established market dominance, drug companies can price gouge freely, raising prices year after year at shocking rates on the medications that they have long since released. These price increases are wholly unrelated to the effectiveness of a drug over time. One study of high-spend drugs showed that seven of the 10 drugs reviewed provided no additional clinical benefit relative to other available drugs to justify their high list price or price hikes.31 Some examples of price gouging are particularly predatory. For instance, the drug manufacturer Mylan faced and settled a series of class-action lawsuits resulting from its widely publicized price increases of more than 400% for the EpiPen.32 In another example, even though the FDA first approved the use of naloxone to treat opioid overdose in 1971, the company manufacturing the drug raised the price from $1 to $150 for a two-pack of nasal spray in the mid-2010’s and charged $4,500 for an auto-injected version of the drug — putting it out of reach for people who needed it.33,34,35 Since then, opioid overdose deaths in the U.S. continued to rise each year, reaching 80,411 deaths in 2021.36 Time and time again, drug companies demonstrate that it is easier and more profitable for them to abuse patent law, limit competition, and raise prices rather than investing in new, innovative treatments that will help people live longer, healthier lives.37 High drug costs do not stop at the pharmacy counter Most people think of high drug costs as a problem when they are filling a prescription. But that is only part of the story. As drug companies continue to price gouge and drug prices go up, consumers are stuck with the bill in more ways than one. That is because drug companies set the list price for their drugs long before they are purchased by the consumer. These underlying prices are paid by insurance providers who in turn pass those high and rising costs along to families and employers in the form of higher insurance premiums. The problem of costs being pushed onto the consumer is particularly pronounced for the 174 million people with employer-sponsored insurance (ESI), because the premium and deductible structure in these private plans are particularly vulnerable to drug pricing increases as compared to the more standardized structure of Medicare or Medicaid.38,39,40 The increased prices charged by drug companies for their drugs become part of the costs analyzed by actuaries to establish updated health insurance premiums, and those increased premiums accrue to all people within an insurance pool, regardless of whether those enrollees take prescription drugs. Put simply, when a drug company abusively increases its prices, the amount insurance companies pay increases, and insurance premiums increase right along with them, for everyone, whether or not they take prescription drugs.41,42 In fact, almost 20% of health insurance premiums are driven by the rising cost of prescription drugs.43 These premium increases result in a cascade of negative impacts on health care affordability for employers and workers alike. In the past decade, health insurance premiums for those with private insurance rose faster than the rate of inflation and workers’ wages.44 From 2012 to 2022, the average premium for family coverage rose 42%, from $15,745 a year to $22,463 a year, and the average premium for an individual rose 40%, from $5,615 a year to $7,911 a year.45 In 2022, health insurance accounted for almost 8% of employee compensation, second only to wages and salary.46 As monthly premiums increase, wages rise more slowly because increased health care costs cause employers to spend more of their annual budgets on employee health care and less on employees’ take home pay.47 This problem is especially concerning for individuals who are already paid low wages and are then forced to contribute a disproportionately high percentage of their wages toward health insurance premiums.48 On top of increased health insurance premiums, high drug prices result in other increased health insurance-related costs in the form of deductibles, coinsurance, and copays — for prescription drugs and other health services alike. With 50% of out-of-pocket spending on medical care (including prescription drugs) experienced through deductibles, increasing deductibles leaves consumers paying more out-ofpocket and exposes more consumers to the full price of their prescription drugs and other health care services.49,50 In 2019, a Consumer Reports survey revealed that 30% of adults who take a prescription drug regularly experienced out-of-pocket cost increases from one year to the next, and 12% said those costs went up by $100 or more.51 The average deductible for covered workers in 2022 was $1,763 for single coverage, and just one year later, in 2023, that average had grown to $2,004.52,53 Increases to deductibles and premiums affect all people with health insurance, regardless of what kinds of care they are seeking, and when taken in combination with the stagnating effect on wages, it is clear that high and rising drugs costs are compounding families’ financial insecurity.54,55

(Scottie, culture writer at CNN, “13% of Americans say they know someone who died after they couldn’t afford health care, survey says,” CNN, , Shah – WH)

More than 13% of Americans – about 34 million people – say a friend or family member recently passed away in the last five years after being unable to afford treatment for a condition, according to a new poll from Gallup and West Health.

(Dan, Research Director, Gallup National Health and Well-Being Index, Omaha, Nebraska, “Millions in U.S. Lost Someone Who Couldn't Afford Treatment,” Gallup, management consulting company, , Shah – WH)

Dovetailing with these results is a rising percentage of adults who report not having had enough money in the past 12 months to "pay for needed medicine or drugs that a doctor prescribed" to them. This percentage has increased significantly, from 18.9% in January 2019 to 22.9% in September. In all, the 22.9% represents about 58 million adults who experienced "medication insecurity," defined as the inability to pay for prescribed medication at least one time in the past 12 months. The increase reflects a marked rise among women of over five percentage points to 27.5%, widening the gender gap to over nine points when compared with the 18.1% rate for men. And while data among both political independents and Republicans are statistically unchanged since September, medication insecurity among Democrats has risen over six points to 27.7%.

The inability of many patients to obtain needed drug therapies due to either high prices or shortages has negatively affected patient outcomes. Nearly 30% of Americans say they haven’t taken their medication as prescribed due to high drug prices, and it is estimated that more than 1.1 million Medicare patients alone could die over the next decade because they cannot afford to pay for their prescribed medications.

The high prices for drugs and shortages of many critical drugs like chemotherapy and IV saline bags also impact hospitals’ ability to provide a range of services to their communities, contributing to wider problems with access to care. Hospitals are major purchasers of drugs for use in patient care, and acquiring costly medicines and securing alternative therapies during a shortage are consuming a larger share of hospitals’ finite resources. As drug prices continue to rise, hospitals have fewer resources available to finance other parts of their operations, such as paying staff and purchasing other supplies needed for patient care.

It turns out $10 can be a matter of life and death, according to a new study on how patients respond to higher health care costs.

Researchers at Harvard University and the University of California Berkeley examined what happened when Medicare beneficiaries faced an increase in their out-of-pocket costs for prescription drugs. They found that a 34 percent increase (a $10.40 increase per drug) led to a significant decrease in patients filling their prescriptions — and, eventually, a 33 percent increase in mortality.

(Council for Informed Drug Spending Analysis, “High Drug Prices and Patient Costs: Millions of Lives and Billions of Dollars Lost,” CIDSA, ., Shah – WH)

Existing Problem