Insurers may be ready to support negotiated drug prices

Cancer drug prices keep rising, up from an average of $129 a month in 1975 to an average of over $10,000 a month in 2010. These drugs are increasingly unaffordable, even with insurance, because the insurance companies keep hiking up the copays. In a new twist designed to keep prices sky high and generate greater revenues, the drug companies are attacking health insurers and allying with cancer groups to advocate for lower copays. It could be the drug companies’ undoing; insurers may be ready to support negotiated drug prices.

You would think the drug companies would be embarrassed by the obscene cancer drug prices they are charging. (Express Scripts says that almost one-third (32 percent) of all health insurer spending on drugs came from one percent of prescriptions for costly specialty drugs.) You would want these drug companies to charge US residents what they charge residents of every other wealthy nation. Instead, they are effectively arguing that everyone with health insurance should pay higher premiums and deductibles.

If insurance companies were to reduce copays for cancer drugs, there’s no question they would simultaneously increase premiums, deductibles and perhaps copays for other services. More people might be able to afford cancer drugs. But, fewer people would be able to afford insurance premiums, deductibles and other health care services.

Right now, four states limit drug copays to no more than $150 a month. And, with Pfizer’s lobbying support, many other states are considering similar limits. But, as Karen Ignagni, head of the health insurers’ trade association explains, “it’s a shell game that’s being played on consumers.” Patients, state governments and employers all end up paying higher health care costs as a result of these caps.

To date, the health insurance industry has not shown any willingness to ally with patients to push for negotiated drug prices. Rather, the drug companies and the health insurers have been allies. Perhaps, the drug companies’ behavior will finally move the insurers to do right by patients, take on the drug companies and argue for drug price negotiation. It’s about time they did. If they do, we would have the drug companies to thank!