Changes to the Health Care System Should Prioritize Patient Affordability

Over the last decade, the breakneck pace of innovation has brought us life-saving treatments and cures for rare diseases, cancer and hepatitis C, among others. Despite these advancements improving the way we treat complex and often debilitating conditions, medicine prices have been growing at the slowest rate in years. 

But while prices for brand medicines have remained stable for the health care system, patients have increasingly been facing higher costs at the pharmacy counter. Furthermore, recent proposed changes to Medicare Part B threaten to restrict access to medicines for one of our most vulnerable populations, seniors. 

These were just some of the pressing issues discussed by a group of leading health care voices brought together by PhRMA for a panel at the Wall Street Journal’s 2019 Health Forum that was moderated by former U.S. Representative Erik Paulsen (R-MN) and featured PhRMA president and CEO Stephen J. Ubl, JDRF’s senior vice president of Advocacy and Policy Cynthia Rice and associate professor at Boston University’s Quelstrom School of Business Rena Conti. 

The conversation touched on the key drivers of growing health care costs in the U.S. as well as potential ways that we can realign the overall system to improve access and affordability for patients. As Rice noted, “If you can have access to a drug that would help you stay healthy, then you’ll have lower costs and better outcomes.” 

These include giving patients more information about their potential out-of-pocket costs. Reinforcing the biopharmaceutical industry’s commitment to transparency, our companies recently launched the Medicine Assistance Tool, or MAT, an online platform that provides patients, caregivers and providers with links to company-developed websites that detail medicine cost information as well as a search engine to connect patients with medicine-specific financial assistance programs.

Another area of focus should be addressing the problems in the pharmaceutical supply chain that impact patient affordability. As Ubl noted, “We think there are significant misaligned incentives in the [supply] chain that need to be addressed, it’s pretty much stacked for the benefit of everyone but the patient.” 

While rebates and discounts from biopharmaceutical companies to payers and pharmacy benefit managers total nearly $170 billion each year, little if any of that is shared with patients. According to Ubl, “Taking that $170 billion and more rationally allocating it across what patients pay at the pharmacies is a key part” to ensuring reforms reduce costs for patients. 

Efforts should also focus on removing policy barriers that stand in the way of new, flexible ways for paying for medicines. Ubl and the other panelists agreed that, “the payment models have to really catch up to the innovation in the science,” if we want patients to be able to access the treatments they need and when they need them. 

As policymakers and others in Washington are debating the best ways to improve Medicare and other key aspects of our health care system, it’s important to put patients’ needs at the forefront of discussions, not short-term solutions that threaten their access to new treatments and cures.