Ask The Advisor: June 2017

Ask The Advisor: June 2017

Is Congress Doing Anything At All To Address Prescription Drug Prices?

Q: I was relieved when the vote to repeal and replace Obamacare failed. Could you tell me if the bill contained any provisions to lower drug costs? What does Congress plan to do now to lower drug costs?

A: Although high prescription drug costs were a top issue during last year’s election, Congress has done nothing to address the problem so far. To the contrary, most of the GOP efforts on the Obamacare repeal and replace legislation have been in the opposite direction. During the struggle to win over conservative votes, Republican leaders proposed changes in the legislation that would allow states to determine “essential health benefits” — like prescription drugs. It is unclear what changes that states would make, and whether consumers would save money on prescription meds.

But Congress is not off the hook. An overwhelming majority of voters still think lawmakers need to do more to bring down the costs of prescription drugs. A new survey of people over the age of 60, by TSCL, indicates that 96% of survey participants think Medicare should negotiate prescription drug prices. Some 87% said they also support allowing the importation of prescription drugs from Canada and European sources where prices are far less.

The reality is that extreme prescription drug prices are driving up costs for both patients and Medicare. Many of the most seriously ill patients have gone untreated when they can’t afford their drugs. For example, one-third of Medicare patients who were expected to use Gleevec — a lifesaving medication that treats leukemia, and costs up to $146,000 a year — failed to fill prescriptions within six months of diagnosis, according to a study in the Journal of Clinical Oncology, for example. High costs even now have a medical name. Doctors call it “financial toxicity.”

The highly-inflated prices of specialty drugs, in particular, are accelerating how quickly people hit their Medicare Part D coverage gap (known as the “doughnut hole”).  That’s when consumers are responsible for an increased share of co-insurance that’s 40% of the cost of specialty and brand drugs, 51% for generics. About 5.3 million people, or about 13% of beneficiaries, hit the Part D doughnut hole in 2015, according to data from the Department of Health and Human Services.

TSCL supports a number of bills that would allow Medicare to negotiate drug prices, including those introduced by Representative Peter Welch (VT) and Senator Amy Lobuchar (MN). In addition, TSCL supports bills introduced by Senator Bernie Sanders (VT) and Representative Elijah Cummings (MD) that would allow the importation of FDA - approved prescription medicines from Canada and other nations where many prescriptions are sold for much less than in this country. To learn more, visit


Sources: “As Drug Costs Soar, People Delay Or Skip Cancer Treatments,” Liz Szabo, Kaiser Health News, NPR, March 15, 2017.