We have written many times over the past year of the growing concern of rising prescription costs, from last year’s Daraprim price increase to the more recent life-saving EpiPen price hike. We have tried to explain why these things happen in the US health care industry, but there are a lot of contributing factors. A majority of Americans still consider prescription costs unreasonable and an important political issue. One thing often pointed out is that medications are often much more expensive in the U.S. as compared to other countries. Pharmaceutical companies have denied this, saying that prices in the U.S. may appear higher because there is no reporting on discounts drug manufacturers give to insurance companies or pharmacies. While many discounts can be 50% or more, the

same medications are often still less expensive in European and other countries than the out-of-pocket costs for Americans. Analyzing a number of prescription medications, Bloomberg found that some drugs cost up to 85% more in the U.S. even after discounts. The list prices for these drugs are often up to 500% higher than in other countries. Pharmaceutical companies set their own prices in the U.S. and are often raised over time (frequently by companies that bought the rights to the formula—not the companies that developed the drug). Private insurers and benefit managers negotiate their own rebates with the drug companies while Medicare, the federal health insurance program under the Social Security Act, is prohibited from negotiating prices directly with drug companies even as…

Drug prices continue to be a major concern for Americans.  According to a Kaiser Family Foundation Health Tracking Poll published today, 77% of those surveyed said medication costs were their number one health concern, reflecting recent headline-making increases.  Furthermore, 63% support government action to lower prescription drug costs as a top priority. Compared to a study by the same organization from August, the results are largely the same with notably increased support of government intervention.   The United States is the only developed nation that allows drug makers to set their own prices. Throughout Europe, Canada, and Australia, governments negotiate the price of drugs with pharmaceutical companies in the name of public interest.  The United Kingdom, for example, negotiates through the National Institute of Clinical Evaluation

(NICE). NICE researches and analyzes new drugs, procedures, and devices and tells the manufacturers the price the UK is willing to pay. These practices make life-saving healthcare affordable to all those who need it in their countries.   In the US, pharmaceutical companies set the price of their medications. These price-points are based on profit margins and what competitors charge for similar products (similar in number of prescriptions; not necessarily similar in function or diagnoses). Sharing a market with $100,000 cancer treatments leads to new drugs trying to match those prices. Steven Pearson, founder and president of the Institute for Clinical and Economic Reviews, a nonprofit that evaluates evidence on medical tests, describes it this way: “It's not a market. It's a drug maker…

Last month, we posted a blog about how many Americans are spending more than $50,000 or even $100,000 a year on medications—more  people than ever before. The information included insured Americans and found that insurance covered an average of 97% of prescription costs for those spending at least $50,000. At NeedyMeds, there are many assistance programs for those who are in need.  However, even with new laws and regulations there are those stuck in between.   There are patients in America that make too much money to qualify for assistance but still not enough to pay all their medical bills.  Patient Assistance Programs (PAPs) and non-profit organizations often have limits to how much income a person or family makes in a year to

be eligible for their services.  Good jobs and good insurance can still leave patients paying huge amounts for prescribed medications.   Some medications for serious or chronic diseases such as lupus can cost $2500 per dose. Even with insurance that pays 80% of the drug price there is a $450 out-of-pocket payment, which does not include monthly insurance premiums or other medical costs.  One hepatitis C drug costs $84,000 for a 12-week course. While some patients end up taking on massive amounts of debt, others opt out of taking their medication at the risk of more serious health problems in the future.   According to Truveris, a drug pricing research firm, the price of prescription drugs rose 10.9% in 2014 compared to 2013. Pharmaceutical companies often blame…

More than half a million Americans had prescription costs over $50,000 in 2014—a 63% increase from the previous year. The increase is associated with doctors prescribing more expensive specialty drugs for diseases such as cancer or hepatitis C. The increase of American patients spending over $100,000 has nearly tripled from 47,000 in 2013 to an estimated 139,000 Americans in 2014.   There are many details in the report done by Express Scripts, the largest US pharmacy benefit manager. About 60% of patients spending over $100,000 were prescribed at least 10 medications, and 72% had scripts written by at least four different prescribers. The highest increases in costs are related to expensive new hepatitis C cures

being introduced, with the number of patients receiving treatment for hep C increasing 733% in 2014. Of Americans spending over $100,000, 32% were taking cancer medications—several of which were approved in recent years. Some of the new drugs for hepatitis and cancer can cost upwards of $90,000 alone. Anti-depressants are among the most widely prescribed specialty medicines.   Health insurance covered an average of 97% of patients prescribed at least $50,000 worth of medications in 2014. By contrast, patients with less than $1000 in prescription costs paid up to 35% of the cost out-of-pocket. The report looked at prescription drug claims of 31.5 million Americans with commercial health insurance or coverage through a federal or state program.   The growth of patient populations threatens the affordability of medical coverage for patients. If one is uninsured,…