Berks County Medical Society Medical Record Summer 2019 - 6

Message

froM the

editor

Who Has the Power
to Push Back on
High Drug Prices?
by Lucy J. Cairns, MD

T

he answer to this question
is at once complicated
and simple. The simple
answer is that the federal and state
governments have the power to
rein in the runaway drug prices
that have become a main driver
of total U.S. health care costs.
Pharmaceutical manufacturers,
insurance companies, and the
PBMs (Pharmacy Benefit Managers) operate in the legal and
regulatory environment established by our government, so the
responsibility for responding to abusive price increases and
other practices which result in Americans paying much more for
medication than citizens of any other country lies with our elected
representatives. They created the current system, and they have the
power to change it.

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So why haven't politicians done more to protect their constituents
from a problem that has been widely recognized for decades and
that is causing great financial and physical hardship for many of the
people they are supposed to be working for? This is where the answer
becomes more complicated. The solution to this problem will
require a multi-pronged approach if significant and lasting change
is to be achieved. The pharmaceutical marketplace is complex and
much of the information needed for rational regulation (such as the
true cost of drug development and the terms of the financial rebates
negotiated by PBMs) are a closely guarded secret.
More significant than the complexity, I believe, is the financial
clout of the industry that sets drug prices. Pharmaceutical
manufacturers' profit margins are among the highest of any industry,
and one source of data on U.S. drug expenditures, IQVIA, estimated
that gross spending on drugs at invoice prices in 2016 added up to
$450 billion. Naturally, drug companies devote significant revenue
to lobbying. Their trade group, the Pharmaceutical Research and
Manufacturers of America (PhRMA), spent $9.91 million on
lobbying just in the first quarter of 2019. Money spent on lobbying
does not automatically 'buy' the intended result, but it does give
these companies a very loud voice in the political process.



Berks County Medical Society Medical Record Summer 2019

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Summer 2019

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