This is part of our Cardinal Way project on promoting civil discussions.
Governor Glenn Youngkin has before him a bill aimed at reducing drug prices by creating a Prescription Drug Affordability Board. He vetoed a similar bill last year, saying there’s no evidence that such a board would really accomplish its aim. We recently ran three opinion pieces on the subject of drug prices.
One opinion piece, by Del. Karrie Delaney, D-Fairfax County and the bill’s sponsor, made the case for the board. Another, by Richmond physician Harry Gewanter, argued similar boards in other states haven’t worked. Del. Tom Garrett, R-Buckingham County, had a third opinion; he called on President Donald Trump to intervene on drug prices. With each of those, we asked readers for input.
Here’s what some of our readers had to say about their experiences with drug prices — and, based on those opinion pieces, their views on whether a Prescription Drug Affordability Board would or would not work.
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After 66% price increase on one prescription, she’ll soon have to decide which ones she can afford
Shirley Bustle McNeil, Roanoke County:
Price on one of my meds has jumped 66%. That’s just ONE of them.
Would a Prescription Drug Afforadbility Board work?
Depends who is on who is on the Board. I would say give it a chance.
I’m going to have to soon decide which meds I can take and which can I afford. When you retire your “salary” does not change much. However, everything is going up in price. We have been retired about 23-25 years — that’s a long time to go without an increase besides the cost of living, which is something like 1%-3%. A real shame to treat the elder this way when we have always contributed to the welfare of our country.
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His meds start at $350,000 a year; insurance reduced that to $6,500, Medicare to $257
Bruce Silverman, Manakin-Sabot:
I take one of the most expensive medications, Cerezyme, costing $350,000 per year. Fortunately it remains covered by insurance. Under commercial insurance with a high deductible it cost $6,500/year. Now under Traditional Medicare, I only pay $257/year. I am concerned that someone will think this drug is unaffordable and restrict payment and then the manufacturer won’t want to sell it at the lower price, decreasing my access to this lifesaving drug.
I think the PDAB looking at just a few choice drugs per year makes little sense. PBM reform where discounts are sent back to the patient in the form of lower drug costs and premiums would be a more comprehensive and more sustainable effort. This approach would cover all drugs for all patients.
Copay, coinsurance and deductibles are barriers to care for many patients. 50% of prescriptions over $100 are left behind at the pharmacy counter causing increased morbidity and mortality. [A study on file with the National Library of Medicine says that for certain prescriptions costing $100 or more, the abandonment rate is actually 75%.] This is shortsighted on the part of the insurers and our system and ultimately causes increased costs in hospitalizations and more invasive procedures.
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His meds cost $11,000 a month for 21 capsules
Brian Bell, Keysville:
I live in Southside Virginia and I have bone cancer. My chemo (lenalidomide, sold under the name Revlimid) is an oral pill that I take daily and is a variant of thalidomide. Thalidomide in case you didn’t know, was commonly given to pregnant women back in the 1950’s and 60’s and was taken off of the market because it was determined that it caused horrific birth defects. You could have bought a truckload back then for a nickel. But then they found out that it was a useful drug in fighting certain cancers. My drug now costs $11,000 per month for 21 capsules. So how can you justify the dramatic increase in the price other than to extort money from someone (or insurance company) when there are no other medical alternatives available?
I don’t know if a Drug Affordability Drug Board could lower the cost of prescription drugs or not. But I think it is certainly worth trying. I support the concept.
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Precription drugs should be free
Scott Brookman, Richmond:
While I worked for VCU = Fantastic health care/CoVa Care. Prices were never a concern.
Would a Prescription Drug Afforadbility Board work?
Yes, but prescription drugs should all be free as basic human rights. America never wants to do what’s the caring, humanitarian thing.
Though I had great insurance coverage, there was often a bit leftover, plus, and of course, I paid for the employee’s portion through my paycheck. Now I am jobless and Cardinal Care/VA Medicaid pays 100%. Sometimes I think, “why get a job?” I would have to go back to paying the employee’s portion for prescription drugs AND medical care. Medicaid takes care of ONE of the major outlays of cash per month. Why give that up?
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Fear is a useful tool to discourage change
R. Macon Rich, Staunton:
Drug costs to the consumer is a shell game with no real insight or concern into the actual starting price of the drug, only the final, after insurance price. The game becomes the starting price can be as high as the manufacturer wants as long as insurance covers enough to make the final price to the consumer a reasonable number. Insurance companies make an inflated margin on their drug plans as the prices are inflated.
The final answer is a total overhaul of the relationship between healthcare and insurance companies. With regard to your question, an Affordability Board might help until this monumental shift could take place. I am skeptical however, as I would expect Phamaceutical companies to shift prices as they learn to play under a different scenario.
The final answer is complete transparency in drug prices and costs. Consumers need information to create awareness in the relationship between prices and the cost of insurance. There is generally a lack of concern regarding the price with a focus only on the immediate out of pocket expense. With gasoline, there may be only a few pennies difference in the pump price per gallon. With drug prices there can be a monumental difference in price between pharmacies and may be dependent upon your insurance or how it may be covered. How can I sometimes get a better price through a free discount drug plan, GoodRx, than I can with a paid drug insurance policy. Given a level playing field and transparency, prices should, similar to other commodities, be roughly the same.
The pharmaceutical industry is a very murky business when it comes to pricing. Fear is also a very useful tool to encourage not rocking the boat with the implication being new drugs may not be developed or supplies may become limited.
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Force brand name drugs to become generic after 5-7 years
Miriam Young, Roanoke:
Tiny bottles of eye medication, 1-2″ high (including the cap!), that are mostly water, would cost me $200-500 per bottle over the 20+ years I’ve been prescribed them. One of them should have gone to generic but they slightly adjusted the strength of the med and so it stayed tier 3 brand all these years. Then they discontinued the larger bottle that cost less, forcing me to buy the smaller, worse deal per ml. Another eye drop drug comprised of two generic Rx is name brand only because it simply offers the two generics in one bottle. Those cost over $200 per bottle at this time. I was able to get them for $30-75 a bottle while I was insured commercially through manufacture coupon programs, but I kept having to reconnect that when I went to pay for them. Prior to FINALLY getting Medicare, I filled as many as I could in the 5 months before I got in Medicare, so I have 3 of each bottle stashed waiting for my use. I will have fulfilled my Medicare Rx plan deductible before needing new bottles, so I will only pay about $45 per bottle the rest of the year. Drug manufacturers must be forced to make proprietary formulas made generic after 5-7 years. [The typical time now is 20 years after a patent is filed, but in practice, after you subtract time for clinical research, the period is often in the low teens.] It’s entirely ridiculous to pay hundreds of dollars for tiny bottles of mostly water each month.
I have problems with both opinion articles. The anti-board article stated that several states tried using PDABs and had $0 savings. I find that hard to believe. The pro-PDAB said “This isn’t about politics…” which also cannot be true. The whole special interest lobbying system and corporations paying huge money to political campaigns creates an intermediary entity standing obstinately between lawmakers making any meaningful changes and we the people, paying the highest Rx costs in the world (in a country that has no public health care system except Medicaid and Medicare!).
I believe forcing brand name prescriptions to become generic after 5-7 years is the best answer. I also agree with limiting advertising.
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‘Anything could help’
Patricia Barber, Portsmouth:
Copays double or tripled on asthma inhalers. Anything could help
