Commentary: We must act now to make medicines affordable
We have a once-in-a-generation opportunity to make medicines affordable for our patients and support the health needs of every family in our nation. As physicians, now is the time to elevate the voices of our patients and act.
Congress is currently working to finalize the provisions included in the Build Back Better legislative package supported by the Biden administration. This is a landmark piece of legislation that will invest in every family and community in our nation.
It is critical for Build Back Better to address some of our nation’s most pressing health needs, including making medicines affordable for our patients, expanding the services that Medicare covers to protect the health needs of older adults, and ensuring access to paid family and medical leave.
As physicians, we know how often our patients forgo taking lifesaving medications such as insulin because they must use the money they have to pay for food and housing. Families should not have to make these decisions in the wealthiest nation in the world, yet so many of our patients, particularly those belonging to communities of color, experience poorer health outcomes and die prematurely because they cannot afford their medicines or care they need.
It is unacceptable that one in four people in our nation cannot afford their medicines. If our patients cannot take the medicines we prescribe, our ability to help our patients is limited.
Making medicines affordable for our patients is an issue of health equity and, as physicians, we must use our power to advocate for change.
There have been several recent iterations of provisions included in Build Back Better, but we must call and email our representatives and senators today to share our patients’ stories and ensure that the final version of the bill includes measures that guarantee every person in our nation has the opportunity to achieve optimal health.
In particular, we must advocate for:
- giving Medicare the power to negotiate prescription drug prices;
- capping out-of-pocket costs for Medicare beneficiaries;
- capping out-of-pocket costs for critical, lifesaving medicines such as insulin;
- preventing the cost of prescription medicines from rising faster than the rate of inflation;
- ensuring no cost sharing for Medicare beneficiaries receiving Advisory Committee on Immunization Practices-recommended vaccines covered under Medicare Part D, in the same way there is already no cost sharing for vaccines covered under Medicare Part B;
- expanding Medicaid to cover individuals in states that have not adopted Medicaid expansion;
- expanding Medicare to include coverage for dental, vision and hearing services;
- expanding home- and community-based services for older adults and people with disabilities; and
- ensuring 12 weeks of paid family and medical leave.
A cornerstone of this legislation should be to allow Medicare to negotiate prescription drug prices, since the savings generated from this will help fund the other health provisions included in Build Back Better.
Although the Veterans Affairs system is able to negotiate prescription drug prices, Medicare is not currently legally allowed to negotiate prices. In a free market economy, it does not make sense that Medicare must pay pharmaceutical companies whatever price these companies set for their drugs, even though taxpayers have already invested in the development of these medicines, since all 356 drugs that were approved by the FDA between 2010 and 2019 had support from NIH funding.
There is significant bipartisan support in the community for this issue, with over 80% of the public stating they believe Medicare should have the power to negotiate prescription drug prices, according to a poll conducted by the Kaiser Family Foundation last month. Further, the Kaiser Family Foundation has shown that Medicare’s ability to negotiate prescription drug prices will not restrict access to medicines.
The ability to afford medicines is not a Democratic or Republican issue — it’s a national issue and, as physicians, we need to ensure that Congress and the administration know how deeply this issue affects each of our patients and our ability to fulfill the oath we took to care for our patients and keep our communities healthy.
In addition to ensuring medicines are affordable for our patients, Build Back Better must support additional health needs of our patients.
Although the current version of Build Back Better leaves out dental and vision benefits for those with Medicare, we must ensure that we care for the health needs of our older adult patients by expanding Medicare to cover dental, vision and hearing services, as good dental health and access to eyeglasses and hearing aids are critical to keeping older adults healthy, active and independent for as long as possible.
Every person in our community requires care from another individual at some point during our lifetime. It is essential that when we or members of our family are sick or when our families grow, we can take the time necessary to fully recover and/or care for our families, so that we may return to work in our fullest capacity. We need to support our nation’s families and the women in our nation who are disproportionately affected by this issue, and advocate for 12 weeks of paid family and medical leave.
To ensure our nation’s families and workforce achieve their greatest strength, we must invest in our families and nation to keep every member of our community healthy with access to affordable medicines and health care, so that we come closer to attaining health equity in our nation.
Every voice is critical and, as physicians, we have a responsibility to use our position of power to make sure that each of our patients’ voices are heard. Until the Build Back Better legislation is passed by both chambers of Congress and signed into law, we have the chance to act to ensure this landmark bill comprehensively addresses the needs of our patients and country.
I would, therefore, urge each of you to call your members of Congress to support inclusion of these essential health provisions in Build Back Better, and to guarantee that they pass this critical legislation in the same way they already passed the bipartisan infrastructure bill, so that we may use our once-in-a-generation opportunity to truly meet the needs of our patients and improve the health of our nation.
Institute for New Economic Thinking. US tax dollars funded every new pharmaceutical in the last decade. https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade. Published Sept. 20, 2020. Accessed Nov. 7, 2021.
Kaiser Family Foundation. Drug price negotiation doesn’t mean the government will restrict access to medicines. https://www.kff.org/policy-watch/drug-price-negotiation-doesnt-mean-the-government-will-restrict-access-to-medicines/. Published Oct. 7, 2021. Accessed Nov. 7, 2021.
Kaiser Family Foundation. Poll: Nearly 1 in 4 Americans taking prescription drugs say it’s difficult to afford their medicines, including larger shares among those with health issues, with low incomes and nearing Medicare age. https://www.kff.org/health-costs/press-release/poll-nearly-1-in-4-americans-taking-prescription-drugs-say-its-difficult-to-afford-medicines-including-larger-shares-with-low-incomes/. Published March 1, 2019. Accessed Nov. 7, 2021.
Kaiser Family Foundation. The public weighs in on Medicare drug negotiations. https://www.kff.org/health-costs/poll-finding/public-weighs-in-on-medicare-drug-negotiations/. Published Oct. 12, 2021. Accessed Nov. 7, 2021.
*Editor's note: While Kuwahara has advocated for the inclusion of health provisions in Build Back Better as a member of the American Medical Women's Association's National Policy and Advocacy Committee and the Doctors for America's National Steering Committee on Prescription Drug Affordability, the views expressed in this article are her own.