| Earlier this week, we debunked pharma’s lies about how drug pricing reforms will hinder innovation and patient access to medications. We also explained how taxpayers played a critical role in funding the research and development of COVID-19 vaccines. See our full campaign to set the record straight on the comprehensive reforms in Congress here. Today, we’ll address pharma’s false claims about out-of-pocket costs. |
? Big Pharma’s Lie: Patients only care about lowering out-of-pocket costs. We don’t need comprehensive reforms.
✅ The Truth: The Truth: We can’t lower out-of-pocket costs without lowering drug prices or we will just wind up paying higher premiums and taxes. We need comprehensive reform.
Summary:
Big Pharma has attempted to create a false dichotomy by claiming patients only want their out-of-pocket costs to go down. That’s simply impossible. In order to lower out-of-pocket costs for patients, we must lower underlying prices, or we will simply pay more in premiums and higher taxes because insurers and federal health plans will make up the difference through cost shifting. Capping out-of-pocket costs without lowering drug prices simply shifts costs – it doesn’t lower them. The Alzheimer’s drug Aduhelm is a prominent example of this process: After the manufacturer, Biogen, priced the drug at $56,000 per year, the Centers for Medicare and Medicaid Services announced that Medicare Part B premiums would increase by nearly 15 percent the following year — one of the largest increases ever — to accommodate the astronomical cost. Passing the comprehensive drug pricing reforms that include Medicare negotiation will address the headwater of the issue — high list prices — and lead to lower prices and out-of-pocket costs for patients.
Taxpayer Perspective:
High drug prices are a major challenge for small business owners and leaders. In a recent statement, Rhett Buttle, senior advisor for Small Business for America’s Future, explains: “We also need to help small businesses with unreasonable expenses that cut into their bottom line and hinder their growth. … Small business owners identify the cost of healthcare and prescription drug prices as their top concern and strongly support solutions like allowing Medicare to negotiate the price of prescription drugs.”
Nevada teacher and type 1 diabetes patient Jamie Tadrzynski writes in the Las Vegas Sun, “Any proposal that caps the cost of one or more drugs will not fundamentally address the root of the problem, which is rising prices. The government can take action to help seniors and others afford their medicine, but without negotiations that actually stop the drug corporations from charging whatever they want and raising prices at will, cost containment can only have limited impact for a limited number of patients while burdens continue to rise for taxpayers, businesses, and those paying premiums.”
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The following organizations are part of the Push For Lower Rx Prices campaign:
| AARP Advancing AZ Alliance for Retired Americans American Academy of Neurology American Federation of State, County and Municipal Employees (AFSCME) American Federation of Teachers American Medical Student Association Authentic Caribbean Foundation Inc. Be a Hero Blue Shield of California Campaign for a Family Friendly Economy Center for American Progress Center for Medicare Advocacy Citizen Action of Wisconsin Colorado Consumer Health Initiative Committee to Protect Health Care Communications Workers of America Community Catalyst Consumer Action Consumers for Affordable Health Care Doctors for America Employers’ Forum of Indiana Families USA FL #insulin4all, T1International Generation Patient Greater Philadelphia Business Coalition on Health Health Access California Health Action New Mexico Health Care For All Massachusetts Health Care Voices Health Law Advocates Human Rights Watch Indivisible Initiative for Medicines, Access & Knowledge (I-MAK), Inc Interfaith Center for Corporate Responsibility (ICCR) Jewish Alliance for Law and Social Action Justice in Aging Knowledge Ecology International KS Business Group on Health Lower Drug Prices Now Main Street Alliance Maryland Health Care For All! Coalition Medicare Rights Center Metro New York Health Care for All MomsRising National Committee to Preserve Social Security and Medicare National Multiple Sclerosis Society New Jersey Citizen Action New Mexico Consumers for Affordable Prescriptions Coalition Nurses for America Oregon Coalition for Affordable Prescriptions Patients For Affordable Drugs Now Pennsylvania Health Access Network People’s Action PrEP4All Prescription Justice Program On Regulation, Therapeutics, And Law (PORTAL), Brigham and Women’s Hospital/Harvard Medical School Progressive Democrats of America Protect Our Care Public Citizen Purchaser Business Group on Health R2H Action [Right to Health] SEIU Social Security Works T1International TakeAction Minnesota Tennessee Health Care Campaign U.S. PIRG United States of Care Universal Health Care Foundation of Connecticut Universities Allied For Essential Medicines (UAEM) Unrig Our Economy West Health Institute |
My name is Cynthia Tidrick and I live in Princeton, WV. I’m 60 years old, work as a contractor for a life science company, and live with emphysema.
Emphysema is a progressive lung disease that, even when treated, leads to shortness of breath and continued scarring. So that I can support myself, perform activities of daily living, and enjoy physical mobility, I need a long acting inhaler called Bevespi. This medication opens my airways and helps me breathe easier. However, Bevespi has become increasingly unaffordable.
I am a Technical Writer and for the last decade have worked as contracted labor. I continue to work contracts, usually six months at a time. Consequently, my health insurance is always precarious. Over the past few years, the cost for my inhaler has ranged by hundreds of dollars depending on my insurance plan. But over the last 18 months, which included two contracts and a period of unemployment, I have paid and continue to pay $449 for a 30 day supply. I am bewildered by the high price of my inhaler.
I have tried other long acting inhalers that were financially affordable, but the side effects were debilitating and required additional medications to treat.
Thus far, I am very lucky to be able to afford my inhaler despite this high cost. But all that has to happen is for my current contract to fail to renew, and I am in trouble. I budget around this cost and keep the price in mind every month. I am 60 and believe I would be better served by affordable medication and saving that $400 dollars a month for my pending retirement. The fewer services I need as a retired senior, the better for West Virginia and the United States tax payer.
Lower drug prices for long acting inhalers like Bevespi would bring peace of mind to me and countless other patients across the country. Having predictable costs over time makes budgeting easier, savings more robust, and we all know less stress makes for a happier public.
Currently, Congress has the chance to pass meaningful drug reforms that would allow Medicare to negotiate lower drug prices, curb drug price increases that exceed inflation, and cap out-of-pocket costs for seniors. I need my Senator, Joe Manchin, to pass these reforms now. West Virginians like me can’t wait any longer for relief from high drug prices.
