Modern Healthcare - Congress

Sen. Mike Braun (R-Ind.) Aggressive approach needed to fix prescripti­on drug market.

- By Sen. Mike Braun

Ibelieve Congress must take an aggressive approach to fixing the nation’s broken prescripti­on drug market. It is opaque and complex. There’s nothing free market about it, except that drugmakers are free to set whatever prices they want.

The market is dependent on things like government-sanctioned rebates and monopolies created by Food and Drug Administra­tion exclusivit­ies and patent abuse. For example, pharmacy benefit managers have perverse incentives to increase their own profits at the expense of patients by paying rebates to drugmakers in exchange for preferred status on insurer’s health plan formularie­s.

It is because of this, according to one study, that drugmakers continue to increase the list prices of drugs, though they receive only about 39% of total spending on drugs. Some 42% goes to various middlemen.

In spread-pricing, PBMs buy prescripti­on drugs from wholesaler­s at one price and sell it to pharmacies at an inflated price. This happens all over the country, with commercial and government-sponsored drug coverage plans.

Reporting by Bloomberg revealed that Indiana residents were paying more than $800 via their private Medicaid plans for a 30-day supply of a hepatitis B medication that cost pharmacies less than $140 to purchase. These plans also paid more than $100 to fill prescripti­ons for a generic heartburn drug—which cost pharmacies less than $25 per prescripti­on. Indiana taxpayers are on the hook for this.

It’s time to fix our system.

Congress needs to shine a light on these unfair drug-pricing practices to pull costs down for Americans who depend on these medicines, especially at a time like this.

Both Senate Finance Committee Chairman Chuck Grassley and I have talked with President Donald

Trump and worked across the aisle to address this broken system. Between the two of us, we have introduced and supported dozens of bills to increase transparen­cy and lower drug costs.

Chairman Grassley’s Prescripti­on Drug Pricing Reduction Act is one of the most aggressive measures to address the costs of drugs—and I am proud to support this bill as an original co-sponsor.

Chairman Grassley and I also recently introduced the Health Care PRICE Transparen­cy Act, which would codify the Trump administra­tion’s healthcare price transparen­cy rules.

This bill will require hospitals and health insurers to publish their actual prices, including for prescripti­on drugs. Under this bill, hospital patients would no longer be forced to pay $150 for a vitamin B injection or $40 for an aspirin, for example.

Americans are blindfolde­d when it comes to healthcare prices only to receive medical bills laden with confusing codes and outrageous charges weeks or months after treatment. Most Americans also do not know how much their prescripti­ons are actually costing them. My bill would fix this.

Of all the perverse traits of our system, the worst is that drug prices are usually higher for the people who can least afford them: the uninsured, seniors and Medicare recipients.

We are approachin­g a breaking point where many people simply will not be able to afford their medication­s. Americans are already starting to trade off filling their prescripti­ons against buying food or paying for other basic necessitie­s.

Now is the time to help the people who are hurting the most. It’s time for Congress to do what we were sent here to do and pass these bills.

Of all the perverse traits of our current system, the worst is that drug prices are usually higher for the people who can least afford them: the uninsured, seniors and Medicare recipients.”

 ??  ?? Sen. Mike Braun
(R-Ind.)
SERVING SINCE: 2019, still in his first term.
HEALTHCARE-RELATED COMMITTEES: Senate Health, Education, Labor and Pensions Committee, Budget Committee, and Special Committee on Aging.
Sen. Mike Braun (R-Ind.) SERVING SINCE: 2019, still in his first term. HEALTHCARE-RELATED COMMITTEES: Senate Health, Education, Labor and Pensions Committee, Budget Committee, and Special Committee on Aging.

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