Most adults surveyed in a new poll said prescription drug costs were unreasonable, with almost one in three not taking prescribed drugs at some point.
According to the Kaiser Family Foundation, these patients skipped a dose, cut pills in half, or took an over-the-counter medication instead. Affordability is especially an issue for people taking four or more prescriptions, those with chronic conditions, and households with incomes below $40,000 a year.
Antonio Ciaccia, CEO of Ohio-based 46brooklyn Research and president of 3 Axis Advisors, formerly of the Ohio Pharmacists Association, said consumers are paying more and more for prescriptions every year.
“Brand-name drugs increase their list prices by about 4% to 5% on average,” Ciaccia reported. “And on top of that, you have new drugs coming to market that are more expensive than the ones that were there the year before.”
Data from AARP revealed that the annual cost of prescription drug therapy increased 26% in Ohio between 2015 and 2019, while revenues increased only 14%.
While every player in the prescription drug market influences prices, Ciaccia pointed to pharmacy benefit managers (PBMs), the intermediaries who decide which drugs will be covered and at what cost to the patient.
He explained that instead of drugmakers competing to drive down prices, they offer discounts and rebates to benefit managers in exchange for coverage of their products.
“Drugmakers are being rattled for ever-bigger discounts,” Ciaccia said. “And to account for those discounts, they raise the prices. And so the PBM that’s supposed to be working on our behalf can get kickbacks, and that dynamic creates artificial price inflation.”
Ohio took steps to reform PBMs after a 2018 investigation found that two PBMs working on behalf of Medicaid managed care plans billed the state nearly a quarter of a billion dollars in more than they had paid pharmacies for the drugs.
Ciaccia called for better accountability and transparency.
“We only discovered this $244 million dumpster fire in Ohio because of the lack of transparency we had,” Ciaccia said. “And increased public access to granular levels of drug pricing data can help us better diagnose malfunctions at the pharmacy counter.”
The Pharmaceutical Care Management Association emphasizes that PBMs help reduce the cost of insurance premiums for consumers. Meanwhile, the Federal Trade Commission is investigating the impact of PBM practices and seeking public comment.
Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.
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