Monday, November 21, 2016

Efforts underway to restrain rising prescription drug costs

- Mara Lambert

In a recent blog post, AAFP President-Elect Michael Munger, MD, addressed an all-too-familiar scenario physicians are encountering in their practices: when medications become too expensive, patients stop taking them. Over the past several years, Americans have faced exorbitant price increases on common treatments such as inhalers for asthma and insulin for diabetes. A Reuters report from this past April found that the prices of four of the top-10 most widely used drugs in the United States increased by more than 100% over the past five years, while six others rose by more than 50%. When steep price hikes for Daraprim and EpiPen made headlines during the past year, the public was justifiably concerned.

Pharmaceutical companies attribute price increases to the cost of researching, developing, and approving new drugs; however, there is a lack of transparency about how these prices are set. Medical societies and other organizations are now upping their efforts to remove the secrecy surrounding drug pricing with the ultimate goal of easing the burden on consumers.

In July, the American College of Physicians released a position paper that outlined various ways to reduce the increasing costs of prescription drugs. Then earlier this month, the American Medical Association announced the TruthinRx campaign to “uncover the truth behind prescription drug pricing.” The campaign’s mission is to improve transparency and restore affordability to medications by educating lawmakers and the public. Website visitors can send a pre-populated e-mail message to their senators and representatives asking them to support calls for increased transparency from pharmaceutical companies and health insurers.

In a similar vein, the Campaign for Sustainable Rx Pricing (CSRxP) is a nonpartisan coalition of physicians, employers, hospitals, nurses, patients, and payers striving to increase awareness of drug pricing and to promote transparency and competition. AAFP leadership met with CSRxP representatives in October to discuss their mutual concerns about drug costs.

The Fair Accountability and Innovative Research (FAIR) Drug Pricing Act (H.R. 6043) of 2016 and the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act (S. 3056) of 2016 are two current bills endorsed by CSRxP. The FAIR Act would require drug companies to disclose price increases greater than 10% and to provide supporting explanations for the increases, whereas the CREATES Act would close a loophole that prevents generic drug companies from accessing samples of branded drugs for research purposes, hence stifling competition.

These initiatives are a start. In the meantime, physicians should remain vigilant about asking patients whether they can afford their medications. In an AFP editorial from earlier this year, Steven R. Brown, MD, outlined five strategies for practicing high-value prescribing, including exercising skepticism and caution when prescribing new drugs, applying STEPS and knowing drug prices, prescribing generics and comparing value, restricting access to drug reps and office samples, and prescribing conservatively. Each of these actions can play a part in keeping costs down for patients and reducing health care spending at large.

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Mara Lambert is Senior Associate Editor of AFP.

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