Discussions about costs are important. We recognize that many are struggling to access the medicine they need and have important questions about their medicine costs. And we want to help find the answers.
That is why we are convening a conversation called Let’s Talk About Cost that takes a broad look at this complex issue, exploring the slowdown in medicine cost growth, the rising cost of chronic disease, insurance coverage of medicine, the role of middlemen and what our industry can do to make medicine more affordable for patients.
Questions you may be asking include:
If medicine costs are growing more slowly, why doesn’t it feel that way?
Multiple sources including Express Scripts, the largest pharmacy benefit manager (PBM) in the nation, confirm medicine spending growth was between just 3 and 5 percent in 2016, the slowest rate in years. Unfortunately, it doesn’t feel that way for patients. That is because insurers are increasingly using high deductibles, which result in patients paying the full list price of a medicine, even if their insurer receives a significant discount.
What is driving up my health care costs?
The biggest cost driver in our health care system is chronic disease. Patients with chronic diseases, such as cancer, diabetes and heart disease, account for approximately 90 percent of all health care spending and are the leading causes of death and disability in the United States.
Why am I paying more than my insurer for my medicine?
Private payers are reportedly receiving rebates of between 30 percent and 55 percent for medicines to treat a number of conditions, including diabetes, asthma and high cholesterol. Yet, these negotiated discounts are not shared with patients who pay a deductible or coinsurance for their medicine. No patient should pay more for their medicine than their insurer.
Who decides what I pay for my medicine?
While biopharmaceutical companies set the list price for a brand medicine, more than a third is rebated back to payers and other middlemen in the supply chain. Ultimately, your health insurer determines what you pay for your medicine out of pocket.
How can we make medicine more affordable for patients?
Biopharmaceutical companies offer patient assistance programs that have helped millions of patients access needed medicines for free or nearly free. They are also working with private health insurers to find new ways to pay for medicine that reward outcomes and lower costs for patients.
These and other questions will be featured in print, radio, digital and social channels throughout the year. Advertisements and promotion will run on a variety of platforms nationally.
To learn more about Let’s Talk About Cost and view the advertisements, visit PhRMA.org/LetsTalkCost.
Robert Zirkelbach Robert Zirkelbach is Executive Vice President of Public Affairs at PhRMA. He joined PhRMA in 2014 after working for seven years representing the health insurance industry. He likes Saturday afternoon BBQs on his deck, traveling, trying new restaurants, and attempting to play golf. He’s an avid, somewhat obsessive, Iowa Hawkeye fan and is lucky to have a wife that loves watching college football on Saturday afternoons.
Topics: Drug Cost