Much has been made of the move by President Donald Trump and the pharmaceutical industry to offer direct-purchase drug programs at heavily discounted rates. Following the announcement of these new programs and TrumpRx, we’ve heard news and opinion pieces from every major outlet, but missing in the conversation is one of the most important voices: the patient. Key questions remained unanswered:
“What does this mean for my care?”
“Does this work with insurance?”
“Why are the costs so much lower?”
The collaboration and outside-the-box thinking regarding new direct-purchase drug programs is an encouraging step for the 8 million people in the U.S. who live with psoriatic disease, including myself. These steps signal a willingness to explore the cooperative, innovative approaches needed to lower the cost of prescription drugs. After years of frustrating inaction, innovative thinking and new approaches are welcome and encouraged for individuals living with chronic disease.
However, the concern is that this ends up being another siloed solution that addresses only a small facet of a health care system that needs systemic overhaul. While some question or debate the feasibility, safety, and affordability of direct-to-consumer drug purchasing, there are vetted, bipartisan health care solutions ready for adoption today.
Currently, we are faced with a health care system that rewards and incentivizes higher prices so that if you get sick, you and your family pay more to keep everyone else’s premiums down. Meaningful pharmacy benefit manager (PBM) reform will bring transparency and accountability to our health care system. And any PBM reform must include the most practical and patient-centric change to date: reforming the practice of step therapy.
The bipartisan-sponsored Safe Step Act has been introduced in both chambers and awaits the return of Congress.
We cannot spend more time perpetuating the game of health care solutions “whack-a-mole” Americans have been stuck in for decades. Our community (all communities) deserves better. All Americans deserve a health care system that prioritizes healthier lives without preying on the sick to cover the costs for the rest.
PBM reform and the Safe Step Act represent two common-sense, sustainable, systemic solutions that can help get Americans the health care they need at prices that don’t cripple their budgets. Since 2017 when the Safe Step Act was first introduced, more than a dozen patient advocacy groups including the National Psoriasis Foundation, the Arthritis Foundation, the Crohn’s and Colitis Foundation, the National Alliance on Mental Illness, and more have led the charge in pushing forward-thinking policy changes needed to advance system-wide change.
Creative solutions to high consumer costs for prescription drugs should be celebrated. But let’s not let that distract from the years-in-the-making bipartisan legislative solutions already sitting before us. We can (and should) do both things.
The question before us is simple: Will we get to celebrate this monumental achievement that bucks the “divided times” trend, or will we squander another opportunity to better the lives of Americans by failing to address what we all agree is a massive problem?
Leah M. Howard is the president and chief executive officer of the National Psoriasis Foundation (NPF). She is a lawyer and patient-rights advocate leading the largest psoriatic-disease support and research nonprofit organization in the world. The NPF represents more than eight million individuals in the United States who live with psoriasis and psoriatic arthritis, with the shared vision of creating a world free from the burdens of psoriatic disease.
Leah has lived with psoriasis for twenty-one years and has more than two decades of experience working with national health and disability organizations, local governments, and leading health-care and research institutions. She believes that solving today’s health-care challenges begins with talking with individuals living with chronic diseases, such as psoriasis and psoriatic arthritis. Over the last decade, Leah has empowered people with psoriatic disease to share their challenges with policymakers at the state and federal levels, as well as with regulators and health-agency leadership. This work has resulted in numerous improvements for the community, including more than forty new state laws improving access to treatment.
Leah has positioned the NPF as a leading voice in efforts to measure value and reflect patient preferences in health outcomes. She has also piloted efforts to engage non-traditional patient-advocacy partners, including health insurers, pharmacy-benefit managers, and employers, beginning with the launch of the NPF Payer Roundtable series in 2016. Under Leah’s leadership, the NPF has prioritized serving all segments of the community. Today, the foundation connects with more than 2.75 million individuals each year through its highly accessible website.
