Drug Prices and Health Care

Drug Prices

In the “New Directions in Health Care” podcast entitled “Why are U.S. Prescription Drug Prices So High?” by the Commonwealth Fund (2017), hosted by Sandy Hausman, and available at The Commonwealth Fund’s website: http://www.commonwealthfund.org/interactives-and-data/multimedia/podcasts/new-directions-in-health-care/high-drug-prices, the Commonwealth Fund takes a look at the problems patients are having with rising prices in health care drugs. The Commonwealth Fund is well-suited to address this topic as it is, according to its mission description, a “private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults” (About Us, 2018). The Commonwealth Fund publishes numerous reports, studies, letters and articles about the state of health care in America today. Its political leanings have been rated slightly left of center as it seeks to avoid partisan politics and focus on how health care can better serve patients but also often publishes “factual information that utilizes loaded words (wording that attempts to influence an audience by using appeal to emotion or stereotypes) to favor liberal causes.  These sources are generally trustworthy for information, but may require further investigation” (Media Bias/Fact Check, 2018). The Commonwealth Fund is affiliated with the Harkness Fellowship, which it sponsors.

The podcast discusses the fact that health care costs are rising in a variety of ways—from pharmaceuticals that are needed to keep people alive, to cost of coverage as premiums and deductibles increase so that insurance companies can meet their own costs. Legislators are slow to react which means that Big Pharma, which spends more on lobbying and advertising than it does on research, continues to rake in profits as it is allowed to set prices high as it argues that it needs the money to conduct research on new life saving drugs. But as the podcast points out, the majority of the actual research is being done by the National Institutes of Health using tax payer dollars—so that argument does not ring true.

An interesting point that the podcast makes is that Big Pharma benefits managers who operate prescription drug insurance programs: the managers can make more from higher priced drugs, as they are negotiating percentage rebates. Additionally, patients within Medicare or who are covered under private sector insurance plans must pay their co-payments and deductibles based on the retail price of the drug rather than the discounted price that the insurance company or the doctor or the hospital pays. This shows that there is inequality in terms of how drugs are sold, and patients are the ones who are being taken advantage of.

This issue is relevant to health policy because the cost of drugs and of coverage is so high already that many people cannot afford them and so either do not take all of their prescriptions (because they are too expensive to re-fill) or they simply do not go in for care. If Congress does not address this issue of cost by either forcing Big Pharma to lower prices or allow Medicare to negotiate prices, health policy in the U.S. will continue to lag the rest of the world, where the cost of care is much lower (Starfield, 2000; Kane, 2012).

This podcast is relevant for DNP practice because nurses must be aware of the financial hardship conditions of patients and of the likelihood that some pharmaceutical treatments may not be used because of cost. For this reason DNP prepared nurses should focus more than ever on providing preventive care to help patients reduce the risk of health decline in the future and of being in a position where they need to rely on pharmaceuticals to stay alive. Preventive care is, at least, one option that health care providers can use for now.

The podcast does not appear to contain any bias and while the Commonwealth Fund has been labeled as slightly left of center politically speaking, the information contained in the podcast is evidence-based and not overtly political. The important take-away from the podcast is that Big Pharma is price-gauging patients and has to be stopped. I also learned that the National Institutes of Health does most of the new research and is supported by taxpayers, so the arguments of Big Pharma are hollow. I would recommend this podcast to everyone concerned about health care so that they could get in contact with their congressman to make a change. All podcasts on health care are interesting to me as I like to have a lot of perspectives on this issue.