More Information on Prescription Medicine Affordability

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Why Virginia Needs a Prescription Drug
Affordability Board

Summary:

 

 

The cost of prescription medicine has drastically increased in the United States and in Virginia over the last decade, and this needs to change. The health of Virginians needs to be much more prioritized, and state officials must implement a Prescription Drug Affordability Board to lower prices for prescription medicine as a way to create transparency and not allow the pharmaceutical industry to profit from American sickness and misery. 

Currently, in terms of public health, Virginia ranks 15th in the nation, however large public health gaps still exist and Virginia can do better. 

For large brand name prescription medicine, the United States pays 3.44 times more than thirty other nations. 

In Virginia, 1 out of 4 Virginians reported that they did not fill their prescription and/or rationed their medicine by cutting their pills in half solely due to cost concerns. 

Racial inequity exists in the public health system as Black and Latine people are twice as likely to be diagnosed with diabetes than White people, and as the price of insulin increases, marginalized communities are more financially burdened as well. 

During the pandemic, in 2020, drug manufacturers raised the prices of over 1000 prescription drugs in 2020, including hospital ICU drugs, cancer drugs, and drugs being repurposed to fight COVID-19, a disease that has already killed over 700,000 Americans, and virtually all 2021 price hikes exceeded the rate of inflation, including a 7.4% increase in the world’s bestselling drug, Humira.

As of right now, Virginia has passed HB 2007 to implement much more transparency as to the reasons behind skyrocketing costs of prescription, however this action is not enough and does nothing to decrease the price of prescription medicine. 

Virginia needs a Prescription Drug Affordability Board, which would have the legal authority to regulate price caps for prescription medicine statewide. Nine states have introduced legislation to implement this, and Virginia is one of them. 

Delegate Shelly Simonds introduced HB 691, the Prescription Drug Affordability Board and Office Act, which would install a Virginia Prescription Drug Affordability Board to regulate and make drug prices more affordable for all Virginians. 

Background:

 

Many Virginians rely on lifesaving prescription medicine, however, it is a well known fact that Virginians have concerns about how they will pay for their life-saving prescription medicine as prices continue to increase drastically while wages have not. Between 2013 and 2016, over 50 percent of Virginians took at least one prescription drug and nearly 90 percent of people 65 and older took prescription medicine as well. In 2019, the average Virginia resident filled 11 prescriptions, and the average annual  cost of a prescription drug treatment increased 57.8 percent between 2012 and 2017, while the annual income for  Virginians only increased 8.5 percent. Based on 2018 data, Americans already pay an average of 2.56 times more in prescription drug prices than thirty other nations; for larger brand-named drugs, Americans pay 3.44 times more than these other nations. And these prices continue to rise as the cost of prescription medicine has risen three times faster than the rate of inflation over the last decade. For example, in 2018,Americans spent $535 billion on prescription drug costs, a 50 percent increase since 2010 that  equates to four times the rate of inflation. Furthermore, prescription drug spending (after manufacturer rebates) accounted for over 21.5 percent of health insurance dollar spending between 2016 and 2018, making it consumers’ single largest expense on insurance premiums. Unbranded prescription drugs accounted for 84 percent of American prescription drug volume, but only 12 percent of prescription drug spending while brand name drugs accounted for only 11 percent of American prescription drug volume and a notable 82 percent of American prescription drug sharing. 

Currently, the state of public health in Virginia is improving, however there are still large inequitable gaps that exist in our public health network. The state is currently ranked 15th in the country in terms of healthcare. The goal is to fill the clearly visible gap of the cost of prescription medicine in the Commonwealth and raise Virginia’s statewide ranking. Virginians already feel the financial burden that prescription medicine occupies in their lives. The cost of prescription medicine has increased 20 percent since 2014, and it comes with no surprise that the majority of Virginians are concerned about these skyrocketing costs. According to a survey of 1,172 Virginia adults, over 50 percent said that they were either “worried” or “very worried” about affording the cost of prescription medicine. Over 1 in 4, 27 percent of respondents, reported that they did not fill their prescription and/or rationed their medicine by cutting their pills in half solely due to cost concerns. 

 

Systemic inequality due to race exists in our healthcare system as well and it shows in price rates, especially when it comes to diabetes, a long-term disease that one needs prescription medicine or insulin for life in order to live. The Centers for Disease Control and Prevention (CDC) classifies diabetes as an epidemic nationally, and Virginians are sadly not excluded from this. Out of 668,000 Virginians, 10.4 percent of the adult population have diagnosed diabetes and another 189,000 have undiagnosed diabetes; moreover, every year, 45,000 Virginians are diagnosed with diabetes.  According to the American Diabetes Association, Virginia paid $6.1 million in direct medical expenses for diabetes in 2017. Today, Black people have twice the mortality rate from diabetes as White people and Latine People have twice the mortality rate from diabetes as White people in addition to being more likely to experience preventable diabetes-related  kidney failure and vision loss. 

The COVID-19 has shed much light on these existing inequalities in our society, but most especially on the American healthcare system. During the pandemic, in 2020, drug manufacturers raised the prices of over 1000 prescription drugs in 2020, including hospital ICU drugs, cancer drugs, and drugs being repurposed to fight COVID-19, a disease that has already killed over 700,000 Americans, and virtually all 2021 price hikes  exceeded the rate of inflation, including a 7.4% increase in the world’s bestselling drug, Humira. 

The majority of Virginians supported four strategies in order to stop price gouging. 88 percent of Virginians support authorizing the Attorney General to take legal action against pharmaceutical companies who increase the price of prescription medicine for personal gain, 88 percent support an increase in transparency where drug companies notify customers in advance of any price increase with a justification, 85 percent support caps, and 85 percent support a law that would prohibit pharmaceutical companies from charging more in the United States than abroad. All of these solutions would help this large, national issue that affects the health of so many Virginians. 

 

One way to implement all of these solutions at once would be for Virginia to implement a Prescription Drug Affordability Board (PDAB) who would have the legal authority to set payment caps based on the affordable prices that people pay for the exact same prescription medicine abroad. The PDAB would also conduct these actions in a transparent manner so that Virginians know and understand the reasons behind the prices of prescription medicine. 

Furthermore, politicians on both sides of the aisle take large amounts of money from the pharmaceutical industry which leaves one to question whether there exists a conflict of interest as the majority of Americans and Virginians who elect these politicians support lower prices for prescription medicine. In the 2020 election cycle, the pharmaceutical contributions to 214 Congressional Republicans totaled almost $7.1 million dollars while pharmaceutical contributions to Congressional Democrats totaled $6.6 million dollars. In calendar years 2019 and 2020, the pharmaceutical industry gave $171,675 to 78 lawmakers in the Virginia Legislature. Virginia is also one of ten states where more than half of all state legislators accepted money from the pharmaceutical industry, the other nine states are: California, Illinois, Oregon, Texas, Louisiana, Florida, Arizona, Ohio, and New Jersey. Given the amount of political and financial influence that the pharmaceutical industry has in Virginia politics, an issue of inequity arises when regular working class and middle class Americans do not have the time or financial resources to demand for lower prices for their life-saving prescription medicine. The top five pharmaceutical industry contributors are: Pfizer, PhRMA, Lilly, Merck, and Novartis.  

 

Source: https://www.statnews.com/feature/prescription-politics/federal-full-data-set/ 

Legislative Summary:

Currently, Virginia Governor Ralph Northam signed HB 2007 on March 24th, 2021, which establishes an annual reporting requirement for manufacturers with respect to 1) brand-name drugs and non biosimilar biologics with a WAC of $100 or more for a 30 day supply or course if treatment and any increase of 15 percent or more in EAC over the preceding calendar year and 2) biosimilars launched with an initial WAC hat is not at least 15 percent less than the WAC of the reference biologic. This law will take effect on January 1st, 2022. Although this law increases transparency for Virginians, it is not enough to actually lower the price of prescription medicine which has been the primary state-wide and national concern. In January, 2020, Delegate Shelly Simonds introduced HB 691, the Prescription Drug Affordability Board and Office Act. HB 691 would officially establish the Virginia Prescription Drug Affordability to study, review, and regulate the cost of prescription drugs in consultation with a stakeholder work group appointment by the board. HB 691 would also create the Office of the Prescription Drug Affordability Board to provide staffing and administrative support. This idea is not new and has already been introduced in eight other states: Arizona, Colorado, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, and Wisconsin. In 2019, the state of Maryland became the first state to enact PDAB legislation, although it only focused on public purchases, not on private ones. Even though all eight states have introduced similar legislation, there are some notable differences to discuss. In Minnesota, the PDAB had the authority to consider drug prices abroad in Canada to decide price rates in the United States. Five states, Hawaii, Maine, Oklahoma, North Dakota, and Rhode Island are already considering using international prices as references but not all of them have specifically introduced legislation for PDABs.

Recommendations:

 

1) It is recommended that the Virginia Legislature pass Virginia should pass a Prescription Drug Affordability Board with the ability to set an upper payment limit so that all Virginians can access their life-saving prescription medicine without worrying about the cost. It is not only the morally right thing to do, but also what is best for the health and economy of the Commonwealth. 

 

 

2)It is recommended that the Virginia Legislature pass a bill to limit or get rid of the power of the pharmaceutical industry on Virginia lawmakers. If that is not possible, it is recommended that Virginia lawmakers who continually receive money from the pharmaceutical industry do not vote on bills that have to do with regulating the pharmaceutical industry. 

 

The Virginia Legislature must keep doing all they can to lower the costs of prescription medicine and implement a PDAB as soon as possible.  

 

Press Releases

For Immediate Release: July 20, 2021 

 

Advocates Launch ‘Virginians for Affordable Medicine’ Coalition, 

Call on House Candidates to Support Prescription Drug Affordability Board

Richmond, VA: Today small business owners, doctors and physicians, patients, consumers, and faith leaders launched a new coalition calling on the Commonwealth’s policymakers to address the growing crisis around the burdensome cost of prescription medicines.  The Virginians for Affordable Medicine coalition is asking all Virginia House candidates to commit to action lowering prescription medicine costs, and to support the creation of a Prescription Drug Affordability Board if elected this November. 

A Prescription Drug Affordability Board would provide Virginia with the ability to set an upper payment limit for consumers on certain specific medicines that are seeing burdensome cost increases. Maryland and Colorado have recently passed legislation to implement similar boards.

With nearly one in four Virginians not taking their prescription medicines due to cost, it is imperative for all candidates for office to commit to action on making medicines more affordable, and outline their plans,” said Maddie Beecher, Executive Director of Freedom Virginia. “We hope all candidates running this year will commit to making Virginians’ health a top priority. As we emerge from this pandemic, Virginia’s leaders must continue to take action to lower the cost of prescription medicines. We look forward to working with all legislators in 2022 to pass this agenda on behalf of all Virginians.”

 

Members of Virginians for Affordable Medicine include: Virginia Organizing, Freedom Virginia, the Baptist Ministers Conference of Northern Virginia, the Virginia NAACP, AFSCME Council 20, Small Business Majority, the National Association of Social Workers Virginia Chapter, Doctors for America, and the National Multiple Sclerosis Society.  

“For as long as Virginia Organizing has worked on health care access, we have heard from members throughout the Commonwealth that they cannot afford the medicine they need to live well,” said Ladelle McWhorter, Chairperson of Virginia Organizing. “We’ve made progress in expanding health care coverage but not in keeping these necessary prescriptions affordable. Every candidate in Virginia should understand how many of their constituents are affected by this issue and commit to taking action to protect consumers and health.”

 

In 2019, the average Virginian filled 11 prescriptions annually.  2016 data showed that nearly 50% of Virginians had taken at least one prescription over the previous 30 days, including nearly 90% of Virginians 65 and older.  At the same time, the cost of those medicines that they depend on is skyrocketing.  The average annual cost of a prescription drug increased 57.8% between 2012 and 2017, compared to only 8.5% growth for the average Virginian’s income.  This burden is taking a major toll, as nearly 1 in 4 Virginians reports not taking medicines as prescribed due to cost.

“As a physician, I see first hand how high prescription drug costs force my patients to split pills, skip their medication and ration their care,” said Dr. Colleen Blanchfield, a neuropsychologist from Reston and member of the Committee to Protect Health Care. “I urge policymakers to take meaningful action to bring down the high cost of prescription drugs.

A review board that will hold pharmaceutical corporations accountable when they raise prices is an important step forward that can help end a broken status quo. Establishing a review panel will send a clear signal that Virginia puts people first and that we refuse to accept business-as-usual any longer.”

“Access to affordable, quality healthcare and prescription drugs are vitally important to small business owners because they and their employees have historically comprised a disproportionate share of the working uninsured,” said Awesta Sarkash, Government Affairs Director, Small Business Majority. “Even before the pandemic, Virginia small business owners had to pay skyrocketing costs for medicines and health coverage, and almost half of all entrepreneurs identified healthcare costs as being one of the two big barriers to maintaining or growing their business. We are proud to support the Virginians for Affordable Medicine Campaign and their efforts to address the rising costs of prescription drugs that are hurting small business owners’ bottom lines. We urge the Virginia General Assembly to make prescription drug pricing more transparent and medicine accessible to all Virginians.”

 

“The high cost of insulin has brought me a lot of emotional distress since I turned 18,” said Cynthia Gonzalez Luna from Richmond, who spoke at today’s announcement. “It sets me back a lot. I don’t have the ability to take a job unless it includes benefits because I need insulin to live. If I don’t take it tonight, I will have to go to the ICU tomorrow. I’ve ended up in the ICU twice. If I didn’t have medical coverage those hospital bills could have put me in debt for years and years.”




For Immediate Release: Oct 19, 2021

Press Contact:  Addison Hunter ahunter@freedomva.org, Jared Leopold

 

Coalition Calling for Affordable Medicine Announces 75 ‘Prescription Drug Affordability Champions’ on November Ballot

 

Bipartisan Group of Candidates Have All Committed to Support Prescription Drug Affordability Board to  Bring Down cost of Lifesaving Drugs 

 

Richmond, VA: Today, Virginians for Affordable Medicine announced 75 “Prescription Drug Affordability Champions,” a bipartisan list of candidates for statewide office and delegates who have endorsed a Prescription Drug Affordability Board to lower medicine costs.

Coalition members from the Baptist Ministers Conference of Northern Virginia and Freedom Virginia hosted an event this morning with Del. Alex Askew, as well as Chris Debo, a Virginian being impacted by the high cost of medicine

 

A Prescription Drug Affordability Board (PDAB) would act as a watchdog to establish fair prices for everyday medications, ensuring that fewer people in the Commonwealth will be forced to choose between their health and basic necessities such as rent and groceries.  

 

 

“I couldn’t be more proud to stand with delegates from both sides of the aisle,” said Del. Askew during the press event. “We must cap the cost of prescription drugs to save millions of people’s lives. That is exactly what the Prescription Drug Affordability Board will do. It will make sure that companies aren’t unethically over-charging folks while making prescription drugs more affordable for all Virginians. […] I’m looking forward to getting this done next session.”

 

“The issue is clear: Virginians are in dire need of someone to regulate the price of prescription medicine,” said Maddie Beecher, Executive Director of Freedom Virginia. “ These 75 Prescription Drug Affordability Candidates show the growing momentum to lower medicine costs in the 2022 legislature. It really boils down to the fact that life saving medications don’t work if you can’t afford to take them. That’s why we’re pushing for a Prescription Drug Affordability Board that brings down the cost of these life-saving medicines.”  

 

“During the pandemic, in 2020, drug manufacturers raised the prices of over 100.0 prescription drugs. These price increases directly impacted our low-income households and our Senior population. A group of individuals who have been struggling to begin with,” said Rev. Dr. Denise Wilson, President of the Baptist Ministers Conference of Northern Virginia, on the call this morning. “This must be a priority and it is crucial that you take action during your administration.”

 

“I am a type one diabetic, and have been since I was 21,” said Chris Debo, a Richmond resident. “I had to learn how to manually perform the functions my pancreas had performed.  If I don’t inject enough insulin I could have complications later on down the road: If I inject too much I run the risk of falling unconscious and dying. I will be coming off my parents insurance at the end of November, if I cannot find insurance by then it will cost me $1,352 dollars a month to maintain the same quality of life I live with now. People have died trying to save money on their insulin, there is no negotiation, there is no budgeting, there are no substitutions.”