U.S. Sens. Christopher Murphy (D-CT) and Shelley Moore Capito (R-WV) recently sent a letter to Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), chairman and ranking member of the Senate Health, Education, Labor and Pensions (HELP) Committee respectively, to review patients’ perspectives on high out-of-pocket costs and their ability to access health care.
“Several health care trends make it difficult to access their care, including high out-of-pocket costs,” the letter said. “Cost-sharing can reach as high as 30-60 percent, causing a significant financial burden and leading (to) poor adherence and non-adherence.”
The letter continued to stress the importance of innovative medicines and how they can improve the quality of life of patients with debilitating, chronic diseases. Addressing delays in patient treatment could save many lives. Otherwise, delays in care could create irreversible damage to patients who need immediate care, which could possibly increase the costs of health care for the patient and the health care system.
“The greatest barriers to care for patients suffering from chronic conditions are the high prices charged for some treatments,” Devon Herrick, health economist and senior fellow at the National Center for Policy Analysis (NCPA), recently told Patient Daily.
Herrick offered some background for why Murphy and Capito are addressing this issue now.
“Research dating back decades found that patients exposed to significant cost-sharing reduce their medical spending by about 30 percent with no noticeable effect on their health,” he said. “Deductibles and cost-sharing have increased over the past decade as more insurers and employers are searching for ways to slow the grown-in medical spending.”
Despite the additional costs to patients, Herrick said cost-sharing has slowed down health spending.
“It’s been effective; the annual rise in health spending has been about 3 percent annually compared to double or triple that amount in years past,” he said. “The problem is that some patients bear costs they can hardly afford.”
Furthermore, innovative drugs are considerably more expensive, which can create conflict between affordability and the best methods of effective treatments for some patients.
“Increasingly, a few drugs are becoming extremely expensive,” Herrick said. “Although only about 1 percent of drugs prescribed, so-called specialty drugs now account for about 35 percent of drug spending. Some specialty drugs cost $1,500 per month, while some cost $1,000 per pill.”
Herrick explained that some limitations on costs are necessary.
“Without any constraint, the sky would be the limit to the price of many of the newest drugs,” he said. “Cost-sharing is a way to encourage patients to try less expensive treatments before moving up to the costly ones.”
Herrick argues that cost sharing is necessary, but caution needs to be applied with regards to caps on cost-sharing and copays.
“There is no easy answer, but it is appropriate that drugs that cost, say, $20,000 per year have some cost-sharing,” Herrick said. “Capping cost-sharing and copays on expensive drugs is the surest way to make drugs even more expensive in the future.”
Other supporters of Murphy’s and Moore Capito’s letter include Sens. Kelly Ayotte (R-NH), Michael Bennet (D-CO), Richard Blumenthal (D-CT), Tim Kaine (D-VA), Angus King Jr. (I-ME), Amy Klobuchar (D-MN), Brian Schatz (D-HI) and Charles Schumer (D-NY).
