A 67-year-old patient, whom I’ll call Herb, recently came to see me for a check-up for his diabetes. He has suffered from complications from diabetes in the past, and his most recent numbers — including his A1c — were poor.
I sat down to talk with Herb, but before I could say anything, he got straight to the point. Herb lives on a fixed income. Although he has Medicare coverage, his out-of-pocket cost for insulin is $400 a month. He knew his A1c would not be good.
“I can’t afford my insulin,” he said. “I haven’t had it in six weeks.”
And no wonder. Since 2001 the wholesale price of a vial of Lantus has spiraled 513 percent, and the cost of a vial of the short-acting insulin lispro ballooned 585 percent — from $35 to $234. During the same time, the price of a vial of human insulin rose 555 percent, from $20 to $131. Between 1987 and 2014, the wholesale price of a vial of Humulin U500 — used by more and more people with diabetes — rose from $170 to $1,200
Herb is not alone in his dilemma. Prices for a host of brand-name and generic prescription drugs have skyrocketed. The widely used antibiotic doxycycline hyclate soared from $20 for 500 capsules in October 2013 to $1,849 in April 2014. The cholesterol medication pravastatin sodium surged from $27 to $196 for a one-year supply.
Like far too many seniors, Herb was faced with a tough decision, and he opted not to adhere to recommended treatment.
Without corrective action, the problem is likely to get worse. Ten years ago, four percent of U.S. workers had high-deductible plans through their employers, according to the Kaiser Family Foundation. Today, one in four workers have such plans — a troubling trend because we know that patients with high-deductible plans are more likely to delay or skip recommended care.
Family physicians are very concerned about this complex patient care issue. Delegates at the recent American Academy of Family Physicians Congress of Delegates adopted an amended resolution that took aim at the skyrocketing price of EpiPens. They directed the Academy to call on the FDA and Congress to “establish mechanisms to prioritize and fast-track competitive drug options for widely used life-saving or life-sustaining drugs that may be subject to monopoly power.” They also referred to the Board a resolution advocating for prescription drug cost-saving measures for Medicare.
According to a recent Kaiser Family Foundation poll, nearly 90 percent of Americans think drug companies should be more transparent about how they set prices, more than 80 percent think the federal government should be allowed to negotiate with manufacturers for better drug prices for Medicare beneficiaries, and nearly 80 percent think prescription drug prices are unreasonable.
The medical community agrees. Working together, organizations representing physicians, hospitals, nurses, patients, insurers and pharmacists are addressing the causes of high drug prices. The medical community is advocating for our patients by calling on Congress and other stakeholders to find a solution that will allow our patients affordable access to the medications they need.
Michael Munger is president-elect American Academy of Family Physicians. This article is adapted from the AAFP Leader Voices Blog.
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