How much is too much to expect Americans to pay for prescription drugs? Unlike just about every other country, which negotiate drug prices, in the United States, Congress permits drug companies to set prices sky high. Not surprisingly, a new Kaiser Family Foundation poll shows that about three-quarters of Americans believe drug prices are not reasonable.
Since insurers must cover medically reasonable and necessary drugs, regardless of the price, drug companies focus on profits and seem not to concern themselves with whether needed drugs are affordable. For example, two new FDA-approved drugs to treat heart disease by lowering LDL cholesterol levels and protect against heart attacks are expected to cost between $7,000 and $12,000 a year. And, Sovaldi, a new drug to treat hepatitis C costs $84,000 for a 12-week treatment. Of note, insurers do not generally cover the full cost of these drugs; patients usually spend thousands of their own dollars in copays and coinsurance for them.
A recent report by Express Scripts details the problem of rising drug costs, reporting that “An estimated 576,000 Americans spent more than the median household income on prescription medications in 2014,” up 63 percent from 2013. And,140,000 people had drug costs of $100,000 or more, three times the number of people with these costs in 2013; slightly more than half of these people were baby boomers, between 51 and 70.
About ten percent of Americans, millions of people, report that they have trouble affording their drugs, according to the Kaiser poll. And, many of them say they are not filling prescriptions or cutting their pills in half to reduce their costs at the expense of their health. No wonder that government drug price negotiation is the top national policy priority for Americans today.
Here are six tips for keeping your drug costs down if you have Medicare.