Prescription Price Setting Threatens Drug Development

By Tyler N. of North Carolina

Champion Profile

Having watched many of my family members suffer from Alzheimer’s, I am deeply passionate about finding a cure for this debilitating disease. This condition impacts far too many families in North Carolina and across the country and, while treatments have improved, I still remain hopeful that one day we will find a cure.

In order for that to happen, biopharmaceutical companies must have all the tools necessary to continue researching and developing new, cutting-edge therapies. That’s why, as an advocate for biopharmaceutical innovation, I am concerned that last year’s Inflation Reduction Act (IRA) could have a chilling impact on innovation for Alzheimer’s research and development.

The IRA includes harmful price-setting policies for prescription medicines under Medicare. While I understand the intent was to help lower costs, in reality, this kind of government control over medications is misguided and could end up limiting patient access to life-saving treatments. Under the IRA, the government is essentially devaluing medical innovation and forcing biopharmaceutical researchers to make difficult decisions on which disease areas to invest in.

For that reason, I worry that if Congress continues to push for additional price controls in the prescription drug market, the chances of ever finding a cure for Alzheimer’s—and a range of other diseases—will diminish. We don’t even yet fully know the impact of the IRA’s price-setting policies, and lawmakers should not rush to give the government even more control over setting prices for medicines.

If Congress truly wants to do something to help patients, then lawmakers should look into curbing the abusive practices of Pharmacy Benefit Managers (PBMs), who have an inordinate amount of power and control over what patients pay at the pharmacy. These health care middlemen own or are owned by insurance companies. Just three PBMs control about 80% of prescriptions right now, and they use that power to dictate where and when patients can get their physician-prescribed medications, treatments and therapies.

Worse still, PBMs will often shirk their responsibility to patients in order to boost their own profits. Instead of passing down the savings they negotiate from drug manufacturers to help reduce patients’ out-of-pocket expenses, PBMs and insurers will simply keep those savings for themselves, as they’ve admitted. Ultimately, that means vulnerable patients continue paying higher out-of-pocket costs for their prescriptions while middlemen rake in the profits.

Reforming these harmful PBM practices will benefit patients far more than government prescription price setting—and will do so without threatening the biopharmaceutical innovation patients like me are depending on.

Prescription Price Setting Threatens Drug Development

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