HHS is looking for ways to shield consumers from high prices. It is holding a day-long forum Friday on the issue that will include employers, insurers, consumers and drug makers, according to the report. Meanwhile, lawmakers are creating a task force to investigate the high prices.
Lawmakers generally agree they need to respond to the rising prices. The pharmaceutical industry sells about $374 billion in prescription drugs each year in the U.S., with most of those costs being covered by Medicare and Medicaid.
Drug makers have defended their pricing practices, calling the perception that drug prices drive up healthcare costs a misconception. Pharmaceutical industry officials often point to three key points in their defense, according to WSJ:
1. Spending on retail prescriptions has stayed at nearly 10 percent of healthcare spending since 2001.
2. Patients usually don’t pay the full price of prescriptions drugs after receiving discounts and rebates.
3. Public discussion on the issue of drug prices undermines the value and benefit the drugs provide patients while overestimating the costs.
4. Drug makers argue the Obama administration and Congress should focus their concern on insurers whose health plans force consumers to pay their entire deductible before drug coverage comes into effect. “It’s new for patients, and that’s been a big shock to them,” said Robert Zirkelbach, a spokesman for Pharmaceutical Research and Manufacturers of America, according to WSJ.
However, the insurance industry blames higher insurance rates on the rising drug prices. “We’re all bearing drug makers’ excessive pricing, and the increases are a direct reflection of those cost pressures,” said Marilyn Tavenner, CEO of American’s Health Insurance Plans, according to WSJ.
One approach HHS might consider as a means of keeping drug prices in check is borrowing from policies already in place in California’s health insurance exchange that cap how much insurers can charge consumers for specialty drugs. About a dozen states have either already enacted or are considering laws that would place caps on the monthly costs of high-price drugs to consumers, according to the report.
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