Congress Takes on Rising Prescription Costs

We’ve all heard the horror stories about seniors forced to choose between life-saving medications and basic food and living expenses. According to a March 3, 2019 National Public Radio report, the insulin Humalog, manufactured by Eli Lilly Company, has increased in cost by over 600% in the last twenty years alone. A 90-tablet prescription of Lyrica, a nerve pain drug manufactured by Pfizer, was $150.00 in 2005. By January of this year, it averages over $650.00 (Elsevier’s Gold Standard Drug Database) before rebates or discounts. These are only two instances! A trip to the pharmacy reveals the extent of rising drug costs Unfortunately, income has not kept pace with often life-saving medications. It’s no wonder we hear of such heartbreaking dilemmas.

Excellent retirement planning does not always make one immune to the effects of high prescription costs. Craig W., a type 1 diabetic and retired Tool Designer for a large aircraft defense firm, stated, “Even with a solid retirement plan and receiving the maximum benefits allowed, I often have to choose between the $1200.00 co-pay for my three month insulin supply and other living expenses.”

Congress is taking a hard look at prescription drug prices, but don’t expect any changes soon. Seven pharmaceutical corporation executives were called to testify before Congress recently to ask them why prescription drug costs were so high. None of the executives could explain why prices here in the United States are the highest in the world compared to other developed countries. However, they offered a myriad of excuses and “solutions” that did nothing to lower costs for the American consumer. 

In his opening statement, Senator Ron Wyden said, “More than a decade of evidence shows that private Medicare Part D plans often do not do a good enough job of negotiating drug prices downward.” He added that, “Medicare ought to be able to use the collective bargaining power of 43 million seniors to get better deals for patients and taxpayers.” Not only would allowing Medicare to negotiate drug prices help lower drug costs, other witnesses before the Senate Committee testified about additional policies to lower costs and improve the Medicare program overall.

Partially in response to the Senate and House hearings, Eli Lilly announced that it would begin selling a generic of the popular insulin drug, Humalog, for half the price. This a step in the right direction for those patients who use the drug, but for those who still pay out-of-pocket, the price is $137.35 per vial. The same drug is available outside of the United States for an average of $30.00 per vial, and this is just one example of out-of-control prescription drug costs.

A recent Kaiser Family Foundation poll found the majority of Americans support government action to rein in prescription drug costs. Moreover, investigation by Kaiser Health News discovered that fully half of all patient advocacy groups receive major funding by the pharmaceutical industry. Many advocacy groups oppose changes to Medicare that would decrease overall costs. It appears to be a vicious circle.

“We are only two months into 2019, and prescription drug prices have already increased at three times the rate of inflation this year,” said Richard Fiesta, Executive Director of the Texas Alliance for Retired Americans. “Drug corporations will not put patients ahead of profits unless they are forced to — and they are spending millions to try to influence Congress to do nothing.”

There seems to be no end in sight to rising prescription drug costs. In the House Committee on Oversight and Reform’s hearings beginning on January of this year, Chairman Elijah Cummings opened the proceedings by stating that “the ongoing escalation of prices by drug companies is simply unsustainable.” 

Seniors bear the brunt of rising prescription costs due to age-related illnesses or conditions. As costs continue to rise, more seniors will be faced with the decision between life-saving medications and basic living expenses. 

Pre-planning for Medicare enrollment can help make a huge difference in one’s senior years. For those already enrolled in Medicare, an annual review during the open enrollment period is always a help. Make pre-planning or an annual review part of your Medicare today.