It goes without saying that we have all felt the effects of inflation; from exorbitant gas prices to heftier bills at restaurants, there have been adjustments we have had to make in our finances. However, for individuals prescribed regularly prescribed medications, these recent price increases have only added to the financial burden associated with the United States’ history of unaffordably high costs of medication.
While many people are already familiar with the alarming price of common drugs such as insulin to treat Type 1 diabetes and Epi-Pens to treat allergic reactions, few people know the magnitude of price discrepancy in medications, especially as the illness becomes less prevalent in the population. For example, Zolgensma, a cure for spinal muscular atrophy (SMA), which is a rare neuromuscular degenerative genetic disorder, has a hefty price tag of $2.1 million (US News), making it essentially inaccessible to the average American, whose median income in 2019 was approximately $31,000 (US Census). Perhaps even more alarming is placing drug costs in the United States in comparison to many of its peer nations, where prescription drug spending is approximately half of what it is in America (Health System Tracker). While health insurance does often help mitigate the out-of-pocket costs for Americans, it still leaves them with a higher bill than these peer nations; not to mention, many individuals in America live without health insurance, leaving them to foot the bill completely on their own. Now, perhaps one is speculating that the specific drugs being sold in the United States simply differ from those offered in peer nations, but this is, again, not the case. The same medications sold in the United States can be up to around 423% more expensive than they are in nations such as Germany, Switzerland, and the UK (Health Systems Tracker). All of these statistics point us to one simple, yet crucial question: Why?
One of the major sources for this economic burden is suggested to be the market exclusivity offered to the drug’s manufacturer (American Journal of Nursing). Brand name medications are infamous for their higher prices than generic counterparts. While many people will opt to purchase the generic version of a medication, in order to save money while also receiving the same treatment as the name brand, the generic option is often not an option for medications. On average, name brand medications maintain their exclusivity for 12.5 years after their FDA approval, meaning that individuals may be forced to pay unreasonable prices for medications for over a decade before there is another, more affordable option (American Journal of Nursing). The culprit for the issue of market exclusivity is the FDA (Food and Drug Administration), who grants the manufacturers this exclusivity, essentially enabling them to name their price as high as they want, knowing that many of their consumers will have no choice but to pay the price or face unfavorable effects to their health. Others have pointed the blame towards physicians for prescribing choice medications when there are other inexpensive alternatives that could be recommended (Kesselheim, et. al. 2016). Perhaps this is due to a disconnect between physicians and their patients; having different financial situations than their patients may make it easy for physicians to forget about the influence that costs can have on their patients’ adherence to recommendations. For this reason, it is absolutely necessary that physicians are intentional about perspective-taking when engaging with patients; this will allow physicians to provide their patients with the treatment protocols that are best suited for their situation.
The issue of high drug costs in the United States is not necessarily a new issue and will not be disappearing without intentional action directed at dismantling the infrastructure that enables pharmaceutical companies to name their price with the main goal of having high profit margins. Efforts addressing the policies utilized by the FDA as well as developing more robust cultural competency training for physicians (something that has become increasingly valued in the healthcare industry) can contribute to changes that can ultimately save the lives of thousands of individuals. Removing these barriers to healthcare and its treatments should be at the forefront of efforts to improve the health of Americans and ensure that people are not paying a price to save their lives.