Cost caps are no substitute for lower prices – Daily Montanan


Congressional lawmakers have promised to tackle rising drug prices for years, but so far there has been little action. Now, Congress may be running out of time as bigger issues like the war in Ukraine and inflation crowd out long-standing issues with more immediate concerns.

Skyrocketing drug prices have made prescription drug reform a major issue for years, as well as one that draws bipartisan support. A recent poll showed that 91% of voters saw falling drug prices as a very important issue in the upcoming election, putting it above COVID-related concerns.

Of course, for millions of people, worry about getting prescriptions long predated the pandemic crisis or the latest worries about inflation. Pharmaceutical companies have been raise prices faster than inflation for years as people of all ages struggle to keep up or are forced to choose between medicine and other necessities.

Thousands of Montanans are desperate for a solution to soaring prescription drug prices, but Congress is missing several chances to get it right and patients have already waited too long. Now is the time, with majority support in the Senate for tackling prices through Medicare negotiations, to pass a bill that would finally put in place common sense reform. which would solve the price increase.

Proposals such as creating a national insulin cap are getting a lot more attention than negotiations these days, but any proposal that caps the cost of one or more drugs won’t fundamentally address the root of the problem, which is rising prices. Our government can take steps to help seniors and others pay for their drugs, but without negotiations that actually prevent drug companies from charging what they want and raising prices at will, cost containment can only have a limited impact for a limited number of patients as the burdens continue to increase for taxpayers, businesses and contributors.

Capping the cost of insulin is a good idea, but it will not prevent, for example, pharmaceutical companies from fixing the price of cancer drugs shockingly high and forcing up to half of cancer patients to go into debt to obtain life-saving treatments. Nor will it stop pharmaceutical companies from raising the prices of common drugs that seniors and the rest of us use every day. Caps may mean individuals pay less at the pharmacy, but they will pay more in premiums and more in taxes for programs like Medicare through cost shifting.

Half the price of drugs in Medicare, the health care program for the elderly, rose faster than inflation in 2020. These premium increases were not tied to any particular drug, but rather to thousands of commonly used drugs. Currently, there is no limit on what seniors pay out of pocket for Part D drugs, causing many to skip doses, not fill prescriptions, or give up other basic needs to obtain their medication.

Congress should address this issue and act to limit out-of-pocket costs, but it should also negotiate drug prices in Medicare as other government agencies already do. Negotiated prices at the Department of Veterans Affairs and Medicaid save these programs and the taxpayers who fund them substantially. Veterans Affairs and Medicaid pay half of what Medicare pays for prescription drugs through negotiated pricing.

We already know that negotiating prices will get consumers a better deal than continuing to give pharmaceutical companies monopoly power to set and keep their prices high. It is this monopoly power that allows companies to raise prices twice a year. In 2022 alone, pharmaceutical companies have already increased the price by more than 800 drugs over 5%. Capping the cost of insulin or any other drug is an important step towards affordability, but it does not stop price gouging from pharmaceutical companies.

Fortunately, Congress has a solution: Combine cost containment measures like an insulin cap and a Medicare seniors spending cap with policies that actually curb rising costs like Medicare negotiations and caps. inflation so that we can prevent pharmaceutical companies from raising prices. faster than inflation.

These are all proposals on the table right now as part of a package that lawmakers broadly support. It’s time to enact them into law and make medicines affordable for everyone.

Tully Olson is the executive director of Big Sky 55+, an organization that seeks to organize Montanans 55 and older in public policy.

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