Reducing Prescription Drug Costs for Consumers, Saving Money for the Government

Right now, everyone in Washington is focused on fiscal issues – getting our financial house in order.  This is something families in Ohio have been dealing with for some time.  We know how to do this.  We can improve health outcomes and simultaneously save money for our consumers and for the federal government.

A couple of years ago, Deborah, a constituent from Columbus, lost her health insurance. In a letter to me she explained, “I have asthma. My Advair costs $240 per month from an American pharmacy (without insurance) compared to $56 from Canada. This is madness.” Frankly, Deborah is right. It is madness to deny Americans the right to affordably secure the medications they need to lead healthier lives. But all too often, many Ohioans, like Deborah, know the toll high prescription costs can take on families. Whether it’s a senior who falls into the so-called ‘donut hole’ coverage gap- a gap when private Medicare Part D insurance no longer covers prescription drugs, or a retiree whose name brand medication is twice the cost of the generic version, we need to ensure that Ohioans have accessible and affordable medication.

Fortunately, thanks to the health law, Ohio families are already saving money on prescription drug costs. Reforms from the health law saved nearly 180,000 Ohio seniors a combined $138.5 million on their prescription drug costs in 2012 alone. That means the average Ohio beneficiary saved $774 in 2012. Since 2010, Ohio seniors have saved more than $278 million.

When seniors are able to afford their medications, they are more likely to adhere to doctor’s orders.  That keeps them healthier and keeps costs down for themselves and Medicare. Prior to the law, far too many seniors were skipping doses or cutting pills in half because rent, heat, and drug costs add up quickly on a retiree’s income.

But while the new health law has made strides, there’s more we can do to reduce prescription drug costs and help American citizens —and the government —save money.

First, we need to let the Department of Health and Human Services (HHS) negotiate discounts on prescription drugs for Medicare- just like the VA can do for veterans. If HHS had negotiating power, then we could save taxpayers an estimated $240 billion over the next 10 years. Those funds would replace about two and a half years of sequestration’s painful cuts. Allowing HHS to have parity with the VA could help us avert painful- and unsustainable- cuts to education, medical research, and Medicaid.

Next, we need to allow for the safe re-importation of prescription drugs.  Now is the time to have an adult conversation in Washington about the cost and health benefits of drug re-importation, of importing American-made medicines from other countries. We must recognize that affordability and accessibility can mean the difference between patients taking a medication for the prescribed length of time and splitting pills in half to make them last longer.

Finally, we need to reduce the amount of time that brand name drug makers can sell biologic drugs without competition from generic drug makers. Biologics — the vital drugs that treat Multiple Sclerosis, arthritis, breast cancer, and other illnesses—are essential to countless Ohioans. Last week, I talked to a mother from Ravenna whose nine year-old son has hemophilia and requires biologic drugs. Thanks to the new health law, her son can maintain his coverage. Unfortunately, however, the co-insurance still places an incredible burden on her family.

Ensuring faster access to low-cost generic biologics isn’t just the right thing to do for patients; it’s also the right choice for our economy. If we were to move from a 12-year monopoly period to a seven year exclusivity period for brand name biologics, then we could see some $3.5 billion in Medicare and Medicaid savings over a decade.

The steps are simple. If we give HHS negotiating power, allow the safe re-importation of drugs, and reduce the monopoly period brand name biologic drug makers enjoy, we can save an estimated nearly $262 billion over ten years.

And even more importantly, we can help save lives.