It’s clear – the cost of medications is rising in the United States. Between 2013 and 2015 net spending on prescription drugs increased by 20 percent*. What’s unclear is how and why prices fluctuate year after year when ingredients stay the same.
Who sets the price for your prescriptions?
Drug price negotiations happen behind closed doors with little public oversight. The negotiators often prioritize maximizing company profits over keeping medication affordable for patients.
Hover over the icons below to learn who has control over how much you pay for your prescriptions.
Pharmaceutical companies make and sell drugs, but don’t explain pricing or why costs can greatly exceed R&D expenses. Some even buy existing drugs, spend nothing on R&D, and still raise prices.
Pharmacy benefit managers
Pharmacy benefit managers strike deals between drug makers and health insurers. These middlemen don’t share their pricing agreements and it’s unknown if savings ever reach patients.
Health insurance companies
Health insurance companies approve treatments, set copays and price out with PBMS how much patients pay for drugs. Often, they decide coverage options based on what maximizes company profits.
When patients are left out, health care suffers.
Like food, shelter and water, access to treatment can be a matter of life or death. Keeping patients and providers in the dark about the decisions surrounding drug pricing can be extremely harmful to individuals. What does that mean for patients?
Unnecessary barriers between patients and physicians
Physicians have the education, experience and first-hand knowledge of clinical conditions to prescribe the best treatment options for patients. Physicians, not a profit-driven company, should decide what medications are most medically appropriate for their patients.
Treatments out of reach for patients
Rising costs of prescription drugs puts life-saving treatments out of reach for patients who rely on them. The ability to afford and access the medication a physician prescribes is the cornerstone of an efficient health care system.
Public health deteriorates in the United States
If treatments become out of reach, ailments go untreated for longer and become harder and more expensive to cure. When this happens on a large scale, overall public health suffers and health care costs rise exponentially.