Congress Could Alleviate High Drug Costs Today

A 450 percent increase in the cost of an EpiPen, and the subsequent public outcry, is but the latest in a string of incidents that underscore the devastating impact that exorbitant drug costs have on everyday Americans — and the powerlessness those Americans feel in the face of entrenched interests that allow the issue to persist.

As the EpiPen case highlighted, absurdly high drug costs are not limited to specialty medications such as those that treat cancer, AIDS and hepatitis. Critical life-saving and health maintenance medications, from EpiPens to arthritis treatments, are also subject to dramatic price hikes. The common denominator is that the manufacturers who raise prices on those drugs are enabled by de facto monopolies that stifle competition and allow for cost increases that go as high as — and often higher than — consumers and insurers can bear.

In many instances, high drug costs adversely impact some of society’s most vulnerable and voiceless members. In the EpiPen case, that meant children. The outrage for those victims generated well-deserved media scrutiny and social media activism, which resulted in a swift rebuke from Congress and Presidential candidate Hillary Clinton. This reaction forced Mylan to offer a token of relief in the form of a 50 percent savings card, followed by another superficial gesture — the introduction of a generic version of its own product.

But how many outrage cycles — which ultimately result in few, if any, substantive changes — must we endure before we try a different approach to alleviating the financial burden faced by Americans who rely on medication to survive? An estimated 35 million Americans did not fill a prescription in 2014 due to its high cost, according to research from The Commonwealth Fund. Those Americans cannot await an outrage-fueled news cycle to provide relief on high drug prices.

Members of Congress from both sides of the aisle, and party leaders including both presidential candidates and Sen. Bernie Sanders, have railed against high drug prices. There is no doubt this issue will continue to earn attention from Capitol Hill, but the reality is that legislative progress is slow on even the most straightforward issues.

Drug pricing is anything but straightforward. A recent study published by the Journal of the American Medical Association cited numerous contributors to high drug prices in the U.S., including legal protections that grant market exclusivity to drug manufacturers, and limits on the ability for public and private payers to negotiate lower prices.

The issue is further complicated by a health care system that allows layers of middlemen — including distributors, insurance companies and Pharmacy Benefit Managers — to have a hand in pricing, each implementing its own markup. Mylan CEO Heather Bresch pointed to this very challenge when defending the company’s indefensible price hike in an interview with CNBC, noting there are “four or five hands that the product touches and companies that it goes through before it ever gets to that patient at the counter.”

So what are Americans, particularly those with low or fixed incomes to do in the meantime? As a patient I spoke with recently put it, “I guess people are just supposed to die if they can’t afford the medicine.” That is a devastating but prevalent perspective. And yet, there is an immediate solution on the table that has seen limited consideration in Congress. That solution is to empower Americans with the freedom to import safe, affordable prescription medications for personal use from Canada.

Importing medications from Canada is not new, but the Internet has made it more accessible to Americans beyond the Canadian border. The Centers for Disease Control estimates approximately one million Americans safely and affordably fill prescriptions in Canada each year. Those Americans save an average of 50-80 percent on prescribed maintenance medications from licensed, certified Canadian pharmacies. In fact, an EpiPen in Canada costs 53 percent less than one purchased in the U.S. and Vimovo, which treats arthritis and saw its own massive increase in recent years, is a fraction of the cost in Canada.

If we accept that drug manufacturers and insurers can compete in a for-profit marketplace, should we not allow average Americans to benefit from that same system by seeking out the least expensive medication wherever it can be safely found?

Allowing Americans to more freely exercise their right to access affordable medications under the guidance of their doctor and from a safe, certified online pharmacy, would provide an immediate and vital lifeline. I urge Congress to align their passionate rhetoric with legislative action.


Rebecca Kelley is the executive director of the Campaign for Personal Prescription Importation, a Washington, D.C.-based nonprofit organization that advocates for Americans’ access to safe, affordable prescription medications from Canada.

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