OpEd: Prescription Drug Advisory Board won’t help consumers (Chicago, IL) — Politicians love to reference the so-called “kitchen table” issues.
Perhaps one of the main “kitchen table” issues facing Illinois families is the price of prescription drugs. Prescription medication can prolong and save lives and help people manage their illnesses, they have become an essential part of healthcare.
So, it is understandable that there is concern about the cost of prescription medication. No one wants anyone to miss out on the medications they need and deserve simply because they can’t afford it.
Support for the creation of a Prescription Drug Advisory Board may come from a place of wanting to helping people in need, but the truth is this solution to the price of prescription drugs won’t accomplish its stated goal.
Proponents of Prescription Drug Advisory Boards have zero evidence these boards actually save patients money. Simply saying that something is going to lower costs is not the same as lowering them.
Prescription Drug Advisory Board advocates can’t point to studies to prove their case because there aren’t any and because deep down, they know the creation of another layer of bureaucracy is only going to add costs – not lower them.
These Boards also limit innovation especially when it comes to rare diseases. Orphan drugs, for instance, are medication aimed at treating rare diseases affecting 200,000 or less people. Developing these treatments is costly but very beneficial to the relatively small number of people who need these drugs. Setting artificial prices well below the cost of developing these drugs will make it difficult for manufacturers to invest in them and it could also lead to manufacturers not making them available in states with a Prescription Drug Advisory Board.
Affordability is certainly an important factor for patients but so is accessibility. Patients – especially those patients with rare diseases – need access to their medications. If manufacturers cannot make the upper price limits work, they may pull affected prescriptions from those states’ market.
If Illinois legislators are truly concerned about the affordability of prescription drugs, they should reject the Prescription Drug Advisory Board proposal and focus instead on reforming the 340B Drug Pricing Program, which is a US federal government program created in 1992. The program requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow these covered entities to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”
However, poor oversight of the program since its creation 30 years ago has empowered hospitals and Pharmacy Benefit Managers (PBMs) to exploit charity care to pad their own profits by capturing the savings intended for needy patients. Under current law, providers are under no obligation to reserve the discounts of such drugs for needy patients or even report what they do with the savings they obtain through 340B. Eligible hospitals known as “covered entities” can obtain all 340B medications from a drugmaker at the discounted 340B price and then bill privately insured patients — and even uninsured patients — for the drug’s full list price, helping themselves to the difference as pure profit.
As a result, the program has expanded well beyond its intended scope. The reality is patients are paying the price as they fail to realize the benefits of a program that they may not even know exists. It is time for lawmakers to reject pie in the sky solutions such as Prescription Drug Advisory Boards and focus on what will actually save patients money – reforming 340B.
OpEd: Prescription Drug Advisory Board won’t help consumers
