Our representatives in the House and Senate are once again considering how to ensure that Americans have access to the medicines they need. Let’s hope that the Democrats have learned the lessons of the past several decades when writing prescription drug policy. If not, they are likely to fail miserably.
Lesson one: To succeed, every American must benefit. Any attempt to help one cohort of the population without also helping everyone else is sure to divide Americans and help Pharma. Lower Medicare drug prices might not mean higher drug prices for working people, but you can bet that Pharma will do its damnedest to claim it will and drive that wedge hard. Pitting one group against another is part of the playbook Pharma has used in state efforts to lower drug prices. Truth be told, drug prices benchmarked to prices other wealthy countries pay, for everyone, is what Americans desperately need for their health and well-being.
Lesson two: Lifting the ban on prescription drug importation could help more people access affordable medicines and would help set a benchmark for fair drug prices based on the international market price. The US imports food safely, we can import drugs safely. In fact, millions of Americans import prescription drugs each year without issue.
Lesson three: Without a benchmark price, the Congressional Budget Office has said that negotiation is not likely to lower drug prices in a meaningful way.
Lesson four: So long as Pharma retains the power to raise drug prices, it will continue to raise drug prices.
Lesson five: So long as corporate health insurers can profit from high drug prices, formularies that don’t cover available generics, inappropriate denials of drug coverage, copays that are higher than a drug’s cost and pharmaceutical company rebates and kickbacks, they will do so. They will put their shareholders’ interests above the needs of their members’ need for affordable drugs. Moreover, insurers and the pharmacy benefit managers (PBMs) that are often owned by insurers are unable or unwilling to use their market leverage to bring down drug prices in a meaningful way.
Lesson six: Lower prescription drug copays are not a solution to unaffordable drug costs unless coupled with lower prices. Otherwise, lower copays will likely mean higher insurance premiums and deductibles as well as higher costs over time.
Lesson seven: Pharmaceutical companies invest too little of their revenue in beneficial drug innovations. The federal government needs to invest in these innovations with the savings it achieves from drug price negotiation.
Lesson eight: One way that Congress can ensure that everyone benefits from legislation that lowers drug prices is to give everyone Medicare for the purpose of benefiting from Medicare drug prices.
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