Improving medical costs for U.S. families
As Congress continues to contemplate what to do about the Affordable Care Act, rising insurance premiums, and other regulations associated with Obamacare, families across the country are trying to pay for prescription drugs.
The rising costs of medications make it increasingly difficult for consumers to meet their families’ medical needs, especially when dealing with chronic diseases or illnesses requiring expensive brand drugs and those not available in a generic format.
Further complicating this problem is the fact that anti-competitive practices by some big pharmaceutical companies discourage generic drug competition, impede the free market economy and limit patients’ access to affordable drugs. These practices increase costs and force consumers to make the difficult choice of buying their medicines or paying for other expenses.
Just last year, taxpayers were able to benefit from almost 3.9 billion generic prescriptions that were dispensed. Although generics account for 89 percent of prescriptions, they account for only 26 percent of total drug costs in the U.S. Moreover, 90 percent of generic copays are under $20, compared to 39 percent of branded copays for certain patients in commercial and Medicare Part D markets.
How does this add up for the average consumer? In our family, allergies are an unfortunate and seasonal occurrence. For many years, we used the brand drug Singulair which costs an average of $3.74 per dose. Once the generic, Montelukast, became available at only $0.17 a dose, we could apply that savings to other medical expenses.
In 2016, on average, the use of generic medicines saved each state $4.9 billion compared to the price of comparable branded medicines. In a state the size of Texas, the savings with generic drugs are even larger. Texas enjoyed a whopping $17.8 billion in savings with generic drugs last year alone.
With these obvious savings and benefits, Congress should work toward legislative solutions that will increase the availability and use of affordable generics for all families. In doing so, we should create policies that recognize the differences in brand and generic markets, while ensuring that necessary development of generic drugs will not be restricted by their brand competitors.
Unfortunately, the abuse of a Food and Drug Administration (FDA) patient safety program, called Risk Evaluation and Mitigation Strategies (REMS) enables brand manufacturers to block the entry of competing drugs for an indefinite period, thereby creating a monopoly and preventing the free market to operate even after the brand product’s patent is expired.
Specifically, REMS has the potential for abuse because it allows for restricted distribution networks, which are designed to protect patients from dangerous medications. However, some brand manufacturers have used this process to prevent generic manufacturers from purchasing samples of their drugs for equivalency testing required by FDA approval. As a result, competition is limited and patients, hospitals, insurers, and the government absorb the higher costs.
One viable solution to counter this practice is to encourage U.S. Sen. John Cornyn and the Texas delegation in the House to support and help pass the bipartisan Creating and Restoring Access to Equivalent Samples Act of 2017 or the CREATES Act. U.S. Sen. Ted Cruz recently joined as a co-sponsor of the legislation. CREATES is a proconsumer and pro-family option that removes barriers to the competitive market thereby lowering costs and increasing access to affordable generic drugs.
In a recent Congressional hearing, FDA Commissioner Scott Gottlieb said “too many patients are priced out of the medicines they need. While the FDA does not play a direct role in drug pricing, we can take steps to facilitate entry of lower-cost alternatives to the market and increase competition. This is especially true when it comes to safe and effective generic medicines.”
Gottlieb highlights an important sentiment felt by many frustrated patients and families in Texas and across America: the inability to pay for the medicines you need.
I am grateful that our family can benefit from the lower cost of the generic drug, Montelukast. With the support of the CREATES Act and other legislative solutions, access to affordable prescriptions — even lifesaving medications — should and can be a reality for other families too.