Editor: As medical students, we hear every day from patients who are struggling to afford prescription drugs. Drug prices have continued to climb at unprecedented and unsustainable rates in recent years. Americans are forced to take a double hit from the pharmaceutical industry (pharma)—we pay at the drug store while our taxes are paying for much of the basic drug research as well.
A huge potential source of savings is a program that covers nearly 60 million Americans—20 percent of the nation—Medicare. When Congress authorized Medicare to pay for seniors’ prescription drugs, pharma managed to slip in an important stipulation—that the program would not be able to directly negotiate drug prices with manufacturers. This provision leaves Medicare a sitting duck. The program’s hands are tied to pay pharma’s price for any new drug that provides marginal benefit to seniors. In no other segment of government is this the case – the military negotiates every potential contract, the post office negotiates for bulk supplies, even Veterans Administration hospitals are able to negotiate drug prices. It was only through a diligent, well-funded industry campaign that Medicare is left without a leg to stand on.
Drug pricing is a priority of the Democrat-controlled House of Representatives, with many potential proposals from a wide array of members. Some will have a definite and immediate impact on the prices Americans see at the drug store, while others are little more than a nod to healthcare consumers while leaving pharma in the driver’s seat. Healthcare consumer advocacy groups, including my organization, the American Medical Student Association, are fighting to give Medicare the ability to fight back. HR1046, the Medicare Negotiation and Competitive Licensing Act of 2019 has over 125 cosponsors and the potential to be a windfall for American taxpayers. The bill repeals the pharma-inserted non-negotiation clause of Medicare Part D, but more importantly, gives Medicare the ability to hold pharma accountable and get results. If a drug manufacturer is not making a good faith effort to negotiate an appropriate, reasonable price (think Martin Shkreli, “pharma bro”), the government would be able to license the ability to make the drug to generic companies. This provision, though unlikely to be used, holds pharma’s feet to the fire and gives Medicare legitimate leverage in negotiation. This proposal is uniquely American because it relies on negotiation and competition to drive down drug prices. If negotiation fails, the government can turn to the free market and generic competition to protect taxpayers from price gouging.
Representative Jennifer Wexton has demonstrated interest in lowering drug prices for her constituents. However, she has yet to cosponsor HR1046, leaving us wondering about her commitment to this cause. The nation has reached a tipping point in terms of taking real action to curb ever-growing healthcare costs. Now is not the time to acquiesce to pharma with mediocre proposals that target only a small subset of drugs and don’t provide a mechanism to get real results when dealing with the industry. Representative Wexton, we need you to take a stand.
Keanan McGonigle, Sterling