Costly drugs imperil health care accessibility

The high cost of prescription medications imperils health care accessibility in the United States. About 25% of Americans are unable to obtain their life-saving prescription medications due to the exorbitant out-of-pocket costs. Unsurprisingly, the U.S. per capita spending on prescription medications is approximately double the per capita amount spent by other OECD [Organisation for Economic Co-operation and Development] countries.

Although many associate the high prices of prescription medications with increased innovative capacity, in reality the soaring cost of prescription medications is secondary to the monopolistic control of various pharmaceutical companies that is made possible through the market exclusivity in the U.S. This market exclusivity facilitates the acquisition of medication patents, enforces the lobbying power of the pharmaceutical companies and causes access to generic medication to be limited.

Furthermore, the United States does not negotiate the price of medications based on clinical value; rather, the market decides the final price — an economic strategy that has numerous global health implications. In the U.S., prescription medications constitute approximately 17% of all personal healthcare expenditures. By the same token, out-of-pocket spending related to prescription medication was 86% higher in the U.S. when compared to other developed countries. As a result, the inaccessibility and the barriers perpetuated by the elevated costs of prescription medications not only provoke financial burdens but risk possible morbidity and mortality outcomes secondary to suboptimal medication adherence. Specifically, in 2021, 8.2% of American adults (ages 18 to 64) admitted to prescription medication noncompliance in the past 12 months in order to reduce associated costs. Individuals with disabilities and/or chronic illnesses or uninsured individuals were also more likely to not take their medication as prescribed due to the immense out-ofpocket costs.

Given the inflated profitability of pharmaceutical companies and their influence on health policy, one can understand the logical rationale behind Congress and state legislators having made minimal progress in terms of lowering prescription drug costs. Therefore, the detrimental effects are also experienced at the state level. Connecticut is frequently in the top 10 states with the highest per capita health care expenditures, with costs averaging 25% more per person when compared to the national average.

Connecticut residents spend more on prescription medications when compared to other Americans. In 2022, 23% of state residents, given the elevated costs of prescription medication, either skipped doses, cut medication dosages in half or did not obtain refills. Moreover, in 2021, Connecticut residents spent the second highest amount per capita on prescription drugs in the nation.

Since economic and health policy are interwoven, health policy reform has the ability to integrate itself in economic reform as well. Thus, the passing of HB. No. 5054 is imperative for the improved economic status of Connecticut residents who take prescription medications. Of note, 5.1% of the state population lacks health insurance coverage, and 57% of the population is afflicted with one or more chronic medical conditions. As a result, HB No. 5054 proposes the establishment of the Prescription Drug Affordability board, which will serve to reduce the out-ofpocket expenses of prescription medication, identify opportunities for consumer savings by studying the pharmaceutical prescription drug supply chain and pricing strategies, monitor prescription drug prices, promote the use of more affordable drugs, and recommend a variety of options that uphold prescription drug affordability, while continuing to support advances in biotechnology. It is important for Connecticut residents to voice their support for this bill and contact their state legislators in order for the lives of residents to not be further compromised by prescription medication cost inaccessibility.

With the upcoming elections looming over the future of all Americans, it is imperative to enact your democratic right to vote, and vote for legislators that not only prioritize economic growth, but public health expansion and appropriate health care spending while mitigating current health-related disparities, barriers and inequities. Jenifer M. Rodrigues is a Master of Public Health student from Sacred Heart University.