In his State of the Union address Tuesday, President Trump said his next major priority is lowering the cost of health care and prescription drugs. Americans spend more on prescription drugs than people pay in any other developed nation, an average of about $1,200 a year.
For some, the cost is so high they’re forced to take extraordinary measures, reports CBS News correspondent Tony Dokoupil. Jon Yeagley said his 21-year-old son has a condition that caused him to start losing his hair around the seventh grade. Only one treatment worked but the drug was not covered by Yeagley’s health insurance. So every three months, he drives 6.5 hours to Canada to buy the medicine.
“So right now, I’m paying $15,000 a year for this medicine, which costs in the United States $53,000 a year which I feel is… at best, criminal,” Yeagley said. “There’s no reason why an American should pay three times what somebody in Canada or Europe or Mexico has to pay.”
That sentiment was echoed by Mr. Trump.
“I am asking Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients, finally,” the president said Tuesday night.
Last week, the administration proposed “a rule to lower prescription drug prices… by encouraging manufacturers to pass discounts directly onto patients” instead of giving those rebates to middlemen known as pharmacy benefit managers, or PBMs. It said “this historic action… moves toward a new system that puts American patients first” while “bringing new transparency to prescription drug markets.”
But the PBMs oppose the administration’s plan saying it will undercut their ability to bargain with drug makers for lower prices., acquired last year by Cigna, is one of the nation’s largest PBMs.
“We get accused of being the middlemen but the reality is the most sophisticated employers and health plans employ us to drive better care at a lower cost,” said Steve Miller, executive vice president and chief clinical officer for Cigna. “In the absence of PBMs, patients or planned sponsors will be spending literally billions and billions more on an annual basis.”
The proposal from the administration would have to be passed by Congress. Meanwhile, consumer advocates recommend you shop around for prescription drugs the way you would for any other product.
“Prices can vary a lot. The same medication could be $8 at one pharmacy and $58 down the street. You just don’t know until you ask,” ClearHealthCosts.com founder and CEO Jeanne Pinder said.
For Yeagley, reform can’t come soon enough.
“To my son, the medicine is priceless. I mean, it’s given him an entirely new identity,” Yeagley said. “I believe it has meant everything to him. It’s made a tremendous difference in his personality and his well-being.”
If you’re wondering if there are lower drug prices out there, our consumer advocate suggests checking online resources like GoodRx and Blink Health. But even then, those prices might not be the lowest. She said the cash price might be lower than your insurance price, so you should always ask your pharmacist.
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