Out-of-control prescription drug prices finally have a solution in Pennsylvania | Opinion

Prescription drug pricing is reaching a crisis point.

A 2018 study showed that between 2012 and 2017, the cost of prescription drugs under Medicare increased nearly 10 times faster than the rate of inflation. And it continues to rise; the prices of more than 400 prescription drugs have already increased by an average of 5% in 2020.

Americans are now spending more than double what we paid for our medications in the 1990s and much more than other developed nations. Annual spending on prescription drugs now exceeds $450 billion and is rapidly becoming one of the biggest cost drivers in our health-care system.

Meanwhile, while patients struggle to pay for their medicines, drug corporations are raking in profits. Between 2006 and 2015, 67% of drug companies increased their annual profit margins, some up to 20%. And their claims that drug prices are driven by innovation simply don’t add up; drug corporations routinely spend more than double their research and development budgets on advertising.

People throughout Pennsylvania are feeling the impact of this crisis. A recent study shows that two in three Pennsylvanians are concerned about the cost of prescription drugs, and many more are struggling to afford the prescription drugs they need, often cutting pills in half, skipping doses, leaving unfilled prescriptions at the pharmacy, or choosing between medications and necessities like food, rent, or utilities.

Kierstyn Zolfo of Bucks County is worried about her future given the rapidly rising prices. Diagnosed with rheumatoid arthritis (RA) several years ago, Zolfo relies on an expensive medication to stop the progression of the disease. She credits the medication — which would cost her over $50,000 annually without insurance — with helping her to remain mobile and continue working. Her job relies heavily on typing, something her RA could put an end to if it were to go untreated.

The astronomical cost of this medication means that she lives in fear of her insurer changing her copays, and, in fact, her copay recently went from $250 to $1,000 per month. She’s still figuring out how her family will pay for the new expense and what she’ll have to sacrifice.

Pennsylvanians overwhelmingly support action that will address the drug pricing crisis. Recent polling shows that nearly nine in 10 Pennsylvanians across party lines support a range of policy solutions that would lower prescription drug prices.

With Washington in gridlock and the Senate unlikely to take up a recent House-passed bill that would take aim at high drug prices, it’s left to lawmakers in Harrisburg to put forward solutions.

Fortunately, a groundbreaking solution to the prescription drug pricing crisis has emerged. Last month, State Rep. Dan Frankel (D., Allegheny) introduced legislation that would directly tackle the high prices people are paying at the pharmacy.

The Prescription Drug Affordability Act — HB 2212 — would give both lawmakers and the public greater insight into how drugs are priced, investigate how specific drug prices impact Pennsylvanians, and create a mechanism to reduce what Pennsylvanians pay for their medications by creating a new entity to directly address high drug prices.

This new entity — the Prescription Drug Affordability Board — would be an independent authority composed of experts in health economics or clinical medicine appointed through a bipartisan process with strong safeguards against conflicts of interest.

The Prescription Drug Affordability Board would have the power to thoroughly investigate any drug that has a cost exceeding $30,000 annually for brand name drugs or $100 per month for generic drugs, has increased more than $3,000 annually, or poses significant cost burdens to Pennsylvanians.

The board could then investigate how the drug is priced, assess its impact on Pennsylvanians, and ultimately set limits that directly reduce the cost that patients pay at the pharmacy.

While the solution is groundbreaking, Pennsylvania isn’t the first to try it. Maine and Maryland have already created a Prescription Drug Affordability Board and are moving swiftly toward lowering drug prices for their citizens. Pennsylvania should do the same.

Antoinette Kraus is the director of the Pennsylvania Health Access Network, the state’s largest statewide health coalition, and is a member of The Inquirer’s Health Advisory Panel.