- The rising prices on medications has been a controversial and lasting issue for consumers, especially in recent months. But healthcare experts are warning against placing the full blame on drugmakers, and are calling on other stakeholders to come up with less costly solutions.
- "I think we can do better at transparency around the cost, but I wouldn't just focus on drugs," Louis DeGennaro, CEO of the Leukemia and Lymphoma Society (LLS), said during a roundtable event hosted by the advocacy organization on Tuesday. "Ten to 15% of the cost of care for a cancer patient is drugs. What about transparency across the rest of the continuum?"
- While drug developers, pharmacy benefit managers, insurers and other organizations have largely turned to finger pointing when determining who's to blame for high healthcare costs, panelists — representing PhRMA, life science consultants, the federal government and patient-focused groups — agreed all parties are responsible for making treatments more affordable and accessible.
The LLS roundtable comes at a time when the majority of Americans, regardless of political alignment, agree that medications are too expensive. Results released Monday from a Kaiser Family Foundation poll found 64% of Democrats, 58% of Independents and 60% of Republicans believe lowering prescription drug cost should be a top healthcare priority for Congress and the Trump administration.
Recent research has also called into question whether some treatments are actually worth their high price tags. ICER, for instance, released reports over the last year that found many multiple sclerosis, multiple myeloma and rheumatoid arthritis drugs aren't cost-effective for the value they deliver.
To that point, panel moderater and Kaiser Health News reporter Liz Szabo asked about the price of Novartis' Gleevec (imatinib), a cancer drug indicated for leukemia that has seen its price multiply over the last decade.
"There's a risk when you ask a question about a drug price trend on a specific medicine," Randy Burkholder of the trade group PhRMA said in response. "You risk missing the forest for the tree. At the same time, you could also ask whether Gleevec is worth 50% less today after having gone generic than it was two years ago."
"Again, I appreciate the concerns with specific price trends with specific drugs, but I think it's important to recognize that within a market that overall is working effectively to manage those costs while continuing to provide incentives for innovation, that the market is doing a pretty good job there – not that we can't do better," he added.
But it's not just drug pricing.
"Patients are faced with just a tsunami of financial issues," DeGennaro said. "Suddenly [they're] unable to work. Sometimes their caregivers, family members, are also unable to work, so that puts a financial burden on the patient. Suddenly they're faced with out-of-pocket costs, insurance co-pays. They're faced with deductibles in their health insurance and so on, and potentially bills for hospitalization and the like."
DeGennaro added that of the roughly 26,000 calls the LLS received in the last year, the bulk involved questions and concerns over healthcare costs. Robin Yarbroff, a researcher with the Department of Health and Human Services, echoed that claim, stating that patients have become increasingly and "passionately" interested in healthcare costs, but worry bringing questions up to physicians will detract from receiving care.
Those examples illustrate the inherent trickiness of transparency. The pharmaceutical industry, according to Burkholder, is currently navigating those waters by providing more information about the value of products in relation to their cost, a move it believes should alleviate some consumer concerns without negatively disrupting the market.
Despite a general consensus among the panel that more work needs to be done, there was some jostling with regard to which stakeholders need to do it.
"One of the things we aren't seeing is enough of the discounts that payers and other purchasers are obtaining actually flowing through to the patient at the point of purchase," Burkholder said. "So I think we can do more to make sure that when patients are paying a co-insurance, that they aren't paying off a list price when the payer is actually paying at a lower rate than that."
Following Burkholder, DeGennaro said that "for patients that truly can't afford it, I think the pharmaceutical industry needs to step up and provide those drugs for free."
"To a significant extent they do this already," he added. "But I'm sure [programs] can be enhanced and we can do more in that arena."