Why Should You Care About Drug Price Negotiation?

written by Skye Sherman - Aug 8, 2022
medically reviewed by Dr. Tolulope Olabintan, MD - Sep 28, 2022

Photo Credit: by Christina Victoria Craft, Unsplash.com
Photo Credit: by Christina Victoria Craft, Unsplash.com

Drug price negotiation sounds like a dry topic for politicians and businessmen to discuss in a dusty board room somewhere. But if you’re a person who relies on prescription medications or ever needs to take a drug, this hot topic is something you should take interest in.

Even if you don’t know much about how drugs are manufactured and hit the market, you should care about the process of drug price negotiation. Many people lobby for prescription drug price reform or a better way for the general public to access the drugs they need at more affordable prices. Whether you know anything about this or not, you know the high (or low) price you paid for your prescription the last time you stopped at a pharmacy.

If you don’t keep up with drug news, you might not know about the latest developments in how prescriptions are sold. Did you know that at the end of June 2022, the U.S. Senate took steps to push forward a bill that would allow for Medicare to negotiate prescription drug prices?

This is important because, as CNBC points out, “Recent government data shows consumer prices for everyday items like food and energy have seen the biggest one-year increases since 1981. Yet for the past several decades, prescription drug prices have risen faster than inflation.”

There’s a prescription drug price problem in America. Read on to learn more and for more information about why you should care about drug price negotiation.

The basics: recent Senate action on historic prescription drug price reform

You may be hearing more about drug price negotiation lately because the Senate recently took action that may change the game for patients and the pharmaceutical industry alike. It’s all part of something called the Build Back Better legislative package.

As Fierce Healthcare explains it, “Senate Democrats have narrowly reached a deal on legislation to give Medicare the power to negotiate for lower drug prices. The Senate [recently released text] that also repeals the controversial Part D rebate rule and installs a cap on monthly cost-sharing payments for Part D and Medicare Advantage plans. The legislative text shows that starting in 2026, the Department of Health and Human Services will choose 10 drugs eligible for negotiation. The next year, the number of eligible drugs will increase to 15, and in 2029 and every year after by 20.”

After all, getting drug costs lower is the number one health concern that Americans have for their politicians this year. The issue is important to Americans, and citizens are demanding that Congress makes their affordable drug promises a reality.

Of course, this action by the Senate doesn’t come without controversy. The pharmaceutical industry is pushing back hard on the proposal. They say that these sweeping price-setting policies passed down from the government are bad news. In their opinion, these reforms could threaten patient access and the power of further innovation in the future.

Still, others applaud the action. This drug pricing deal comes onto the table at a time when “healthcare groups and other stakeholders have been fervently pressing Congress to extend enhanced subsidies for Affordable Care Act plans that will expire after this year,” according to Fierce Healthcare.

In addition, the nation’s largest nonprofit organization that is dedicated to people aged 50 and older (otherwise known as AARP) issued a statement from Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer. The statement read:

“AARP is pleased that the Senate is ready to take action on a reconciliation package that includes allowing Medicare to be able to negotiate lower prices for prescription drugs. This is monumental and years in the making. For far too long, America’s seniors have been paying the highest prices in the world for their medications.”

AARP raises a good point! The elderly population is among society’s most vulnerable population. Threatened access to the drugs they need is not only dangerous, it reflects poorly on the health of our society at large.

AARP also points out that this legislation, for the first time ever, “would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that seniors pay for their prescription drugs each year and impose penalties on drug companies that raise prices faster than the rate of inflation.”

The way that AARP sees it, this is a necessary next step in the effort to make drugs more affordable for patients. Allowing Medicare negotiation is a big, important step in helping lower prices for all Americans, including those who belong to the aging population.

What you need to know about drug price negotiation to save money on prescriptions

So, what does all of this have to do with you? A lot! It’s only by making your voice heard that change is made. Senate is only tackling this issue with seriousness now that Americans have made their voices loud enough and demanded change.

While the high cost of drugs has long been a concern for Americans, it’s only now, after many years of pushing toward this goal, that it is actually becoming a reality. It should serve as a reminder that you must lobby, campaign, protest, and vote for what you want (and what you don’t). If you support this initiative from the Senate, you should join your fellow citizens in pushing for it. Think of it as a relatively simple and free way to save money on prescriptions.

If this legislative package continues to move forward, you can expect to see lower drug prices in many categories, especially if you’re a senior citizen. That’s usually good news for consumers, even if the pharmaceutical industry has their doubts.

Is it too good to be true?

You may think that sweeping drug price reform that seeks to lower the cost of drugs to patients could only be a good thing. And you might be right. But there are always other sides to the story.

The Boston Globe reports, “Critics argue that the United States is the only developed country where the federal government doesn’t negotiate prescription drug prices and that a 40 percent cut to the pharmaceutical industry’s size will have limited or no impact on future cures or pandemic preparedness. If it all sounds too good to be true, that’s because it is.”

Why do they say that? In their viewpoint, mandating the government to set prices on some of the most widely used drugs is asking for trouble. They say these price controls “shrink the sector by 40 percent or $100 billion per year in revenue” when the fact of the matter is that the entire industry “invests about $100 billion per year in research and development.” The R&D process is a big thing in America. In fact, the United States makes up more than half of the globe’s spending on R&D.

Insufficient profits means insufficient funds for some of the pharmaceutical industry’s most vital work, leading research and development efforts in the discovery, formation, and creation of new drugs that have the power to dramatically change patient lives and outcomes. In practice, what this means for patients is that treatments are rationed and access to new medicines is delayed.

Maybe getting the government involved in the setting of drug prices won’t get to the root of the issue. But as many people see it, at least it’s a start. Next up, we could consider designing health plans that don’t shift so much cost to the sick in order to keep premium costs lower for the healthy. Distributed more evenly may lower costs overall for everyone. The US system is undoubtedly flawed, but one of its redeeming qualities is that the emphasis on research and development means that new innovations become available to patients at a much faster rate.

Want to hear a surprising stat? The Boston Globe shares, “Americans have access to nearly 90 percent of new treatments launched between 2011 and 2017, while French patients have access to only 48 percent of them and Canadians just 44 percent.”

The article continues, “We all want innovative medicines and to be ready for the next pandemic. We also want costs to go down. Unfortunately, the current proposal by House Democrats would cut our industry’s revenue by 40 percent — while ignoring broken health plan designs — stopping innovation dead in its tracks. And, we would lose a vital strategic asset for our country.”

Both sides have a point. Where do you stand?

How to save money on prescription drugs

Still need help in the present day? Not able to wait for the promise of prescription drug price changes to come? The good news is that there are other ways to save money on prescription drugs beyond what’s out of your control. Even if the drug is priced high, there are ways you can lower your cost by buying smart.

One of the main ways to save on prescription drugs is to purchase from an online Canadian pharmacy. Online pharmacies can stock drugs manufactured in other countries, such as India, Canada, and other places, and the cost is often much lower than what is available on American markets.

Another way to save money on prescription drugs is to reduce your dependence on them, wherever safe and possible. Of course, you should not make any changes to your drug routine without consulting a doctor. But if it’s approved, you can work to live a healthier lifestyle while eating nourishing foods and caring for your mental health, and that will potentially reduce your demand for certain prescription drugs. For example: treatment-resistant depression is different from a seasonal mood disorder, but giving your brain the best you can is a vital part of overall brain, mind, and body health



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While the above article is based on thorough research, we do not claim to offer a substitute for medical advice from a qualified healthcare provider. The article was written for information and educational purposes only. We aim to provide helpful information to our readers, but cannot provide a treatment, diagnosis, or consultation of any sort, and we are in no way indicating that any particular drug is safe or appropriate for you and your individual needs. To receive professional medical attention, you must see a doctor.