Why do prescription drugs cost so much?

Higher drug prices = higher health costs

Soon we’ll be finding out how much our health insurance will cost next year. Premiums are set to rise by double digits across the country.

While uncertainty about the future of the Affordable Care Act (ACA) is partly responsible, insurance companies put the biggest blame on the skyrocketing cost of prescription drugs.

Why are prescription drugs so expensive? To understand the problem in less than 2 minutes, watch this YouTube video…

As the video points out, Medicare can’t negotiate lower drug prices for seniors. For congress to implement Medicare Part D (prescription drug coverage) back in 2006, it needed the votes of politicians who supported Big Pharma. The drug companies helped craft a provision that banned price negotiations.

Then the ACA came along in 2010 and mandated all health insurance cover prescription drugs.

Because a majority of people have drug coverage through Medicare, Medicaid or other health insurance and are not paying the full cost out of pocket, drug companies felt more justified charging higher prices.

But the costs are so great that those without insurance can’t afford them, and insurance companies are finding more ways to ration high-cost drugs or have patients pay more out of pocket. That means higher premiums, higher deductibles and higher-copays.

What can we do about it?

Not much, unfortunately.

Congress can do the most by regulating costs, removing the ban on Medicare price negotiations, and/or making it legal to import prescription drugs from Canada.

Two consumer groups, Patients for Affordable Drugs and the AARP, are lobbying in Washington to support these changes. Check out their websites for more information.

For patients who are having trouble paying for prescription drugs, take a look on my Resources page for links to drug pricing tools, or read these previous posts:

Deprescribing prescription drugs—Maybe you don’t need all the drugs you’re taking.
Do you know your drug formulary?—Depending on your pharmacy benefit manager (PBM) one drug of a certain type (eg statins) might be cheaper than another.
5 tips to save money on prescription drugs

If high drug costs are affecting your budget and quality of life, don’t stay silent. Talk to your physician. Talk to your insurance company. Contact your state’s insurance ombudsman. And definitely call or write to your state’s representative and ask that he or she work with their colleagues to find a solution!

Sláinte,

Frugal Nurse

I’m not a fan of Big Pharma. Here are some books that explain why 😀

: Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

: Overdosed America: The Broken Promise of American Medicine

: Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare