WASHINGTON, DC — Mindy Solango starts making sure she has the medications and devices she needs to treat her type 1 diabetes every day.
“As soon as I wake up my feet hit the ground, check where we are,” Salango said.
She takes about seven to eight insulin injections a day and uses a continuous glucometer.
“With insulin and everything, it’s about $350 a month,” Salango said.
It was even harder years ago when she was a single mom with a different insurance plan.
At the time, she was paying around $500 a month.
“It got really difficult,” Salango said. “I was rationing insulin, I wasn’t eating as much.”
For diabetics, insulin rationing is life-threatening.
Salango’s struggle to pay for her medications inspired her to become an advocate for lower drug prices.
She even voiced her concerns to leaders in Washington, D.C. in December 2021 when she shared her story alongside House Democrats at a press conference on drug prices.
“Our only option is pay or die,” Salango said at the event. “It’s not about health care. It’s the survival of the rich.
Salango’s frustration mirrors homes across America.
We filed for registration with the Federal Trade Commission (FTC) and found nearly 100 public complaints about various prescription drug pricing issues over the past three years.
In April 2020, a New Jersey man wrote about his wife’s struggle to pay for liver medications after enrolling in Medicare.
“This drug costs $2400.00 per month,” the consumer said. “We are both retired. Someone help. WITHOUT THIS DRUG, SHE DIES.
In October 2021, a Seattle consumer wrote that he was struggling to pay for testosterone medications and was battling with the insurance company to get timely approvals.
“It can be extremely harmful and even cruel to patients who are wrongly denied, and causes unnecessary pain and suffering,” the consumer wrote.
AARP has been pushing lawmakers for years to pass legislation to curb rising prices.
According to AARP, the average retail price of nearly 150 widely used prescription drugs has jumped more than 300% over the past 15 years.
“I don’t understand why our representatives are allowing this to happen,” Salango said. “When is enough, enough?”
This is a question we asked on Capitol Hill.
Members of both parties seem to agree that this is a problem that needs to be solved, but disagree on how to solve it.
In fact, the House Oversight Committee released two different reports on drug prices – one from each party.
Role of pharmaceutical companies
In December 2021, Democrats on the House Oversight Committee released a 269-page report after a three-year investigation into drug prices.
Democrats are pointing the finger at unfair trade practices in the pharmaceutical industry.
“Internal strategy documents show pharmaceutical companies have targeted the U.S. market for price increases — while maintaining or lowering prices in the rest of the world — in part because Medicare cannot negotiate directly,” the report says. report.
The report highlighted the sharp rise in drug prices in the United States
“The companies investigated by the Committee have collectively raised prices more than 250 times on the drugs they sell,” the report said. “Eight of ten companies took more than 20 price increases on a single drug. As a result, the median increase in total price since the launch of the drugs in the Committee’s survey is almost 500%. »
The report also addresses the concerns of opponents of government regulation of drug prices who argue that oversight would limit innovation.
“The Committee’s investigation found that the justifications frequently given by the pharmaceutical industry for raising prices – including research and development (R&D), manufacturing and other costs – are not substantiated,” the report said. report. “The Committee’s survey found that business investment in R&D is far outweighed by revenue gains.”
In response to the findings, the pharmaceutical industry accused Democrats of trying to push an extreme agenda.
“Like the disastrous bill championed by Democratic leaders, this misleading report fails to address the abusive practices of insurance companies and intermediaries who profit from a broken system when patients cannot afford to pay. ‘buy their drugs,” said Debra DeShong, executive vice president of public affairs at Pharmaceutical Research and Manufacturers of America (PhRMA). “This so-called survey ignored the real affordability issues people are facing, such as increased deductibles and other out-of-pocket costs. This is nothing more than a partisan exercise in justifying an extreme proposal that will restrict patients’ access to life-saving cures and treatments. We believe there is a better way to reduce costs at the pharmacy while preserving choice, access and innovation. We are committed to working with policy makers on common-sense, bipartisan solutions that address the real affordability issues facing patients.
Democrats on Capitol Hill are maintaining efforts to regulate some drug prices.
“The pharmaceutical companies are engaging in some really unethical practices,” said Sen. Maggie Hassan (D-NH). “They take a lot of different measures to artificially inflate prices.”
We spoke one-on-one with Hassan about the ongoing debate about how to tackle rising drug costs.
“It’s unacceptable that people have to make these choices between buying their prescription drugs or putting food on the table,” Hassan said.
Hassan co-sponsored bipartisan legislation with Sen. Bill Cassidy (R-LA) called the “No Surprises Act” that put an end to surprise medical bills.
This proposal was enacted at the end of December 2020.
Hassan is now focused on containing drug costs and has held public forums with his constituents to hear about their personal struggles trying to afford the drugs.
“How are Republicans and Democrats coming together to come to an agreement to actually solve this problem? Washington correspondent Samantha Manning asked Hassan.
“First of all, the most important thing we can do to fix this problem is to allow the Medicare program to negotiate prices with pharmaceutical companies,” Hassan said. “It’s something I’ve been pushing for a long time and it’s something we really need to stay focused on and hopefully some of my fellow Republicans will join us.”
Pharmacy benefit managers
Meanwhile, House Republicans say Democrats have focused too much on drug companies and not enough on what they call “middlemen.”
Republicans on the House Oversight Committee published a report in December 2021 titled: “A Congressional Perspective: The Role of Pharmacy Benefit Managers (PBMs) in Pharmaceutical Markets”.
PBMs are companies that administer prescription drug benefits on behalf of insurers, including private companies and Medicare and Medicaid.
“PBMs use their leverage in the market to increase their profits, not to reduce costs for consumers,” the report states. “Drugmakers are actually raising their prices because of PBMs.”
“PBMs increase patient co-payments,” Rep. James Comer (R-KY), the ranking member of the House Oversight Committee, said in November 2021 during a forum on the role of PBMs.
“PBMs also have immense control over patient formularies, which allows them to steer patients toward more expensive drugs because those drugs offer them higher discounts,” Comer said. “Without greater transparency of PBMs, it is difficult to see how these tactics benefit patients.”
In response to the report, the Pharmaceutical Care Management Association (PCMA) defended PMBs and said lawmakers should instead focus on the “true drivers of rising drug costs.”
In a statement, PCMA said: “Any report that focuses solely on Pharmacy Benefit Managers (PBMs) appears to be deliberately narrow-minded and will therefore miss the mark. PBMs are the only entity in the drug supply and payment chain that actually reduces prescription drug costs for patients. Instead, policymakers should focus on increasing affordability for patients through increased competition, market forces, and a focus on valuing scarce health care dollars.
Despite urgent appeals from constituents to members of Congress on both sides of the aisle, there is still no large-scale plan to reduce the cost of prescription drugs that enjoys broad support from both parties.
President Biden’s Build Back Better plan included a proposal to allow Medicare to negotiate drug prices and he would have capped the cost of insulin at $35 a month for some people — but that proposal all but died in Congress.
Salango said she had this message for lawmakers as they work to find a solution.
“It’s not a partisan issue,” Salango said. “Diabetes didn’t ask me if I was a Democrat or a Republican. We are all struggling and you need to listen.
This is a developing story. Check back for updates as more information becomes available.
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