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The State and Consequences of Dermatology Drug Prices in the United States
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This article summarizes issues related to rise in prescription drug costs that were addressed by the American Academy of Dermatology (AAD)/AAD Association (AAD/A) Task Force on Drug Pricing and Transparency. Costs are rising for prescription medications due to causes such as FDA regulation, industry mergers, and deals that have been negotiated among manufacturers, health insurers, and pharmacy benefit managers. Additionally, access to medications can be hindered by burdensome prior authorization requirements and restrictive formularies with tiered structures. Out-of-pocket costs are leading to treatment deviation or abandonment, and lack of transparent pricing restricts the ability of physicians to consider cost in choosing appropriate medications. The Task Force addressed the myriad issues and suggests steps for improvement.
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This article provides information about the current state of drug pricing and access, as well as ways that these factors may affect patient access and treatment. While there are current state and federal initiatives to improve the problems, the authors state that it will take continued collaboration between the AAD, dermatologists, and other healthcare system partners to improve the situation. There is a related online resource available.
– Sarah Churton, MD
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersIn 2014, Medicare expenditures increased 12%, the largest increase reported since 2002, resulting in major concerns by both patients and physicians. Although costs are rising for both specialty drugs and generic medications,2,3 out-of-pocket costs, restrictive formularies,4 and health plan bureaucracies are limiting patients’ access to necessary medications. In response, the Regulatory Policy Committee of the American Academy of Dermatology (AAD)/Association (AAD/ A) convened a Task Force on Drug Pricing and Transparency.5 This editorial summarizes the issues addressed by the task force along with relevant AAD/A policy (Table I).
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The State and Consequences of Dermatology Drug Prices in the United States
J Am Acad Dermatol 2016 Jul 13;[EPub Ahead of Print], J Albrecht, M Lebwohl, MM Asgari, DD Bennett, A Cook, CC Evans, LJ Green, JA Hodge, AS Kourosh, ME Maloney, LM Howard, EA Olsen, SP Rosenberg, A Rubin, DB Stough, SC Taylor, BA BrodFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
In the US healthcare system, it is an unfortunate state of affairs that a significant proportion of patients cannot get the medications recommended by their physicians. The AAD taskforce on drug pricing has highlighted the major barriers of the current system: step therapy, opaque pharmacy benefit management (PBM) agreements, and restrictive formularies. The AAD taskforce also makes specific recommendations. This is a good starting point on the journey to developing an improved system. Cited recommendations include transparency in drug pricing and rebates throughout the supply chain, less restrictive formularies, regulated step therapy that prevents arbitrary obstruction preventing the patient from obtaining necessary medication, reasonable out-of-pocket costs, and FDA-regulated drug importation.
The free market does work and is self-regulating, but its equilibrium appears to be maximizing the profits of the supply chain at the expense of a large percentage of the patients it serves. Government intervention is needed to protect our citizens. No single regulation will solve all the ills of drug price gouging; however, rules must be implemented to ensure access to the medicines our patients need. Regulation must be even-handed to avoid disincentivizing pharmaceutical innovation.
We must make ourselves heard to our government representatives at all levels. A coordinated effort between physicians and patients can win the day. If we fail to exercise our voice as citizens, then we deserve the current state of affairs.