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Many hurdles remain for prescription drug access

Health Care and Health Insurance
by David Dillon
Many hurdles remain for prescription drug access
Many hurdles remain for prescription drug access

The average American now relies on multiple prescription drugs in their daily life, and that's an issue that seems to only be growing more prevalent as time goes on. With drugs designed to treat everything from temporary aches and pains to chronic illnesses, there are plenty of drug options for just about any ailment, but experts note that the cost and availability of these medications often combine to severely limit choices for many.

As of the end of last year, about 173 million Americans received their health insurance through an employer-sponsored health insurance plan, of which nearly half were high-deductible plans (with price tags of at least $1,350 for individuals and $2,700 for families), according to the Medication Access Report from Cover My Meds. That share was up more than 30% from 2007.

Problematically, prescription drugs are often quite expensive, and deductibles have risen six times more than wages on an annual basis over that period of a decade-plus. Premiums have likewise risen over the same period, albeit not as sharply, at about 2.5 to 3 times wage growth. That doesn't count the more than 1 in 3 people who need prescription drugs but are either under- or uninsured.

As such, Americans who are prescribed some kinds of medications, particularly the more expensive ones, are increasingly likely to give up those prescriptions or not get them filled in the first place. Almost 70% of people who were prescribed a drug that cost more than $250 abandoned it, but more than 1 in 5 with costs between $40 and $50 did the same.

Cost and access to prescriptions is a major issue for millions.Cost and access to prescriptions is a major issue for millions.

What's being done?
The cost impact of high-priced prescription drugs is hardly a secret, and lawmakers at the state and federal levels have long been working on reasonable solutions to this ever-growing concern. However, amid the novel coronavirus pandemic, help has largely ground to a halt, with The New York Times reporting that drug-price control legislation has effectively stalled with many seeing bigger fish to fry in handling the fallout from the pandemic. 

Senator Chuck Grassley, an Iowan who chairs the Senate Finance Committee, has made drug prices a sort of pet project in recent years and has been working to put some kind of language regarding it into coronavirus relief bills, though he has not made much progress on this front for a litany of reasons, the Times noted. That lack of traction has led some to worry that such relief from Congress isn't in the offing any time soon.

For its part, the Trump administration recently announced a series of executive orders intended to help lower drug prices, including the long-awaited rule that will allow individual states to import certain kinds of medications to keep costs down, and more protections for diabetic patients who need low-cost access to insulin. When these changes will actually be implemented remains to be seen.

Industry solutions on the way?
In the absence of immediate action at the federal level, private entities are increasingly recognizing the issue of people being unable to afford or easily obtain their prescriptions, and working on creating solutions of their own. Arizona-based television station KGUN recently reported that Tucson Medical Center has introduced a pair of self-serve kiosks for refilling prescriptions and buying over-the-counter drugs in an ATM-like format.

This may save patients the hassle of having to schedule doctor's appointments or waiting to see a pharmacist to refill their prescriptions; they can just use the kiosk to order free next-day delivery of their drugs with follow-up calls from the tech company that created the kiosk to make sure everything went according to plan. If the kiosks prove popular with patients, care providers and other companies may add more locations for these devices in the near future.

Addressing concerns
Of course, there is one area where there may be simply too much access to low-cost drugs: when it comes to opioids. Fortunately, the medical community has largely come together to address this issue, recognizing how serious the epidemic of addiction has become in the U.S. as a whole. The latest progress report from the American Medical Association's Opioid Task Force shows that headway is being made: Prescriptions of these drugs dropped by more than 37% from 2014 to 2019, a decline of about 90 million individual prescriptions.

Meanwhile, prescriptions of the anti-overdose drug naloxone have risen by orders of magnitude, from only about 6,600 in 2015 to more than 1 million last year, indicating just how much the medical community has done to get its arms around the problem. However, instances of overdose deaths stemming not from prescription opioids, but illegal counterparts like fentanyl substitutes and heroin, continue to rise, albeit at lower rates than those seen a few years ago.

Certainly, the issue of affordable, effective prescription drugs is one the medical community and lawmakers alike need to do more to address, especially as the novel coronavirus pandemic continues to spread and millions lose their health insurance. This is an issue for everyone to monitor, and try to craft reasonable solutions for, as time goes on.



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