Congress needs an aggressive approach to fix prescription drug market

I believe Congress must take an aggressive approach to fixing the nation’s broken prescription drug market. It is opaque and complex. There’s nothing free market about it, except that drugmakers are free to set whatever prices they want.

The market is dependent on things like government-sanctioned rebates and monopolies created by Food and Drug Administration exclusivities and patent abuse. For example, pharmacy benefit managers have perverse incentives to increase their own profits at the expense of patients by paying rebates to drugmakers in exchange for preferred status on insurer’s health plan formularies.

It is because of this, according to one study, that drugmakers continue to increase the list prices of drugs, though they receive only about 39% of total spending on drugs. Some 42% goes to various middlemen.

In spread-pricing, PBMs buy prescription drugs from wholesalers at one price and sell it to pharmacies at an inflated price. This happens all over the country, with commercial and government-sponsored drug coverage plans.

Reporting by Bloomberg revealed that Indiana residents were paying more than $800 via their private Medicaid plans for a 30-day supply of a hepatitis B medication that cost pharmacies less than $140 to purchase. These plans also paid more than $100 to fill prescriptions for a generic heartburn drug—which cost pharmacies less than $25 per prescription. Indiana taxpayers are on the hook for this.

It’s time to fix our system.

Congress needs to shine a light on these unfair drug-pricing practices to pull costs down for Americans who depend on these medicines, especially at a time like this.

Both Senate Finance Committee Chairman Chuck Grassley and I have talked with President Donald Trump and worked across the aisle to address this broken system. Between the two of us, we have introduced and supported dozens of bills to increase transparency and lower drug costs. 

Chairman Grassley’s Prescription Drug Pricing Reduction Act is one of the most aggressive measures to address the costs of drugs—and I am proud to support this bill as an original co-sponsor.

Chairman Grassley and I also recently introduced the Health Care PRICE Transparency Act, which would codify the Trump administration’s healthcare price transparency rules.

This bill will require hospitals and health insurers to publish their actual prices, including for prescription drugs. Under this bill, hospital patients would no longer be forced to pay $150 for a vitamin B injection or $40 for an aspirin, for example. 

Americans are blindfolded when it comes to healthcare prices only to receive medical bills laden with confusing codes and outrageous charges weeks or months after treatment. Most Americans also do not know how much their prescriptions are actually costing them. My bill would fix this. 

Of all the perverse traits of our system, the worst is that drug prices are usually higher for the people who can least afford them: the uninsured, seniors and Medicaid recipients.

We are approaching a breaking point where many people simply will not be able to afford their medications. Americans are already starting to trade off filling their prescriptions against buying food or paying for other basic necessities.

Now is the time to help the people who are hurting the most. It’s time for Congress to do what we were sent here to do and pass these bills.

The 116th Congress: Policymaking Amid the Pandemic