It’s Prescription Drug Prices, Stupid!
By ANDRE WENCKER
It’s Prescription Drug Prices, Stupid!
Since 2014, drug prices have increased by 33%, outpacing any other medical commodity or service.
Most observers anticipate this trend to go on, despite all measures taken or promised by the government and/or the pharmaceutical industry.
Drug costs represent over 25% of health plans costs
The HCCI (Health Care Costs Institute), a not for profit organization working on a dataset representing over 50 million commercially insured individuals, stated in its annual Healthcare Costs and Utilization. Report that drug costs represent now roughly 25 % of commercial health plans costs.
Diagram, borrowed from a GoodRx study, in September 2020
Prescription drug cost growth accelerated in 2020
Another recent study from Mercer can be summarized in the graph below. Prescription drug costs per employee rose 84.5% during the last ten years!
The author adds:
”Even though these [specialty] medications treat only 2% or less of the population, they account for 51% of drug benefit costs.”
Other data from HCCI suggest that the rising costs are not only due to the price tag of breakthrough treatments for cancer, HIV or multiple sclerosis. People with multiple chronic condition see their drug costs 5 to 6 time higher on average than those with none, and represent over 30% of the total drug spending.
The Mercer study proposes 6 different solutions to manage this significant and growing cost.
Personal drug importation, an easy and effective solution
More than 2 million Americans every year choose another one: personal drug importation.
People living closer to the Canadian border can go there and fill their US prescriptions with secure medications. A former FDA official made this abundantly clear during his testimony before Congress in 2019:
“Canadians have safe drugs and if you go into a brick and mortar pharmacy and you purchase a drug, you’re getting a safe and effective drug. I have confidence in the Canadian drug regulatory system.”
For people living further away from Canada, another option is available: international pharmacy mail-order programs to get Canadian drugs in their mailbox. This is exactly what we do at Care2care International.
There are some restrictions however: temperature controlled (most injectables) or scheduled drugs are not allowed in our program per FDA regulations.
Are international mail-order programs legal ?
We keep hearing from some plan sponsors that they heard that these programs were illegal: this myth has been promoted by the pharmaceutical industry and can easily be debunked. Many international program operators or Pharmacy Checker’s Gabriel Levitt will confirm that personal drug importation is protected by Congress.
As early as 2003, Section 804(J) of the Food, Drug and Cosmetic Act, Congress declares that “the FDA should exercise discretion to permit individuals to import prescription drugs for their own use that do not appear to present an unreasonable risk to the individual.”
In 2018 Congress passed bipartisan Opioid legislation, curbing the importation of illicit drugs among other measures. The bill expressly excluded importation of medications for personal use from the enforcement measures the CBP would take on behalf of the FDA in application of the law.
How do international mail-order programs work ?
Care2care can currently offer hundreds of brand products with huge savings, as some examples are shown in the table below.
The process is straightforward: Care2Care will analyze an anonymized report of the claims provided by the plan administrator to generate a list of products representing the brunt of the plan’s drug costs and the savings estimate.
The plan sponsor and their advisor will propose incentives to plan members such as zero copay, and no deductibles. This is key to generate plan members enrollment and help retain them in the program.
For all these reasons, simplicity, safety and cost saving, plan sponsors should adopt this easy solution and help plan members who need it join the more than 2 million Americans using personal drug importation as a lifeline.