Running head: PHARMACEUTICAL COMPANIES VS.

AMERICA 1

Pharmaceutical Companies vs. America

Cassandra Levchuk

Delaware Technical Community College

PHARMACEUTICAL COMPANIES VS. AMERICA 2

Pharmaceutical Companies vs. America

In the last five years, the United States has shown an increase in spending on

prescriptions from both insurance companies as well as out of pocket from the patients.

Medicare’s spending on prescription drugs has increased from being 2% of the budget in

2004 to 29% of the budget in 2014. Prices in the United States are higher than in other

developed countries and 1 in 4 Americans express difficulty affording their prescriptions.

Four policy actions have been recommended to help drug prices including requiring

pharmaceutical companies to publicly release information on how they set their prices,

allowing Medicare to negotiate prices, limiting charges for high priced drugs, and

allowing the United States to buy imported drugs (Cox, Kamal, & Jankiewicz, 2016).

This is important for the American public because a good amount of treatment courses

for diseases are medications, some people requiring life-sustaining medications and the

need is great for affordable medications and accessibility in order to improve quality

health care.

There are many people supporting this movement from all different parties with

goals involving decreasing prescription drug prices and have introduced and sponsored

many current and pending laws related to the subject discussed further. Some of these

politicians include Senator of Iowa, Chuck Grassley- Republican, Senator of Vermont,

Bernie Sanders- Independent party, and Representative of Maryland Elijah Cummings of

the Democratic party. Also potential Democratic presidential candidate Senator Amy

Klobuchar, D-MN introduced a bill regarding importation of drugs along with Senator

Grassley. On a more personal level, former Delaware Senator Ted Kaufman is in support

of this movement. Also, locally, Kerri Evelyn Harris of Wilmington, a potential

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Democrat Senator of Delaware is running against Sen. Tom Carper. Both support the

lowering of prescription drug prices but Carper states he will go along with what is

happening federally for this matter where, Harris says, “that's not enough”. With an

abundance of support in regards to this topic, it seems the goals and laws of reducing

prescription drug costs will all go through.

Here are some examples of the laws that have been created to address this issue in

the United States as well as laws still going through the legislative process. The 340B

Drug Pricing program is a helpful law put in place in 1992 that requires drug

manufacturers to provide out patient medications to eligible facilities meeting specific

requirements. This allows patients to get the medications they need to go home on and

manage their diseases at a discounted rate. Facilities that are a part of this are typically

hospitals. Another bill related to this issue is the Affordable and Safe Prescription Drug

Importation Act introduced by Senator Bernie Sanders in 2017, which amends the

Federal Food, Drug and Cosmetic Act to allow importation of affordable and safe drugs

to the United States. Of course there are many requirements as far as the manufacturers

we purchase from and controlled substances or anesthesia drugs cannot be imported. This

is a major law for us because now we have access to drugs from more manufacturers

offered at a cheaper price. For example, Canada has many options regarding much

cheaper prescription drugs (S.469, 2017). This is saving money for hospitals and facilities,

pharmacies, and patients. Furthermore, the Improving Access to Affordable Prescription

Drug Act addresses a long list of things regarding prescription drug prices and

affordability specifically one of our goals listed above being Medicare & Medicaid

(CMS) being able to negotiate prices of certain prescription drugs under the Medicare
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program (H.R. 1776, 2018). The goal of this law is to save our federal government

money funding Medicare covered prescriptions at whatever expenses the pharmaceutical

companies order. Lastly, the Lower Drug Approval Competition Act put into place in

2017 as well, requires the FDA to prioritize approval of generic options in cases of drug

shortages, only one type of this medication currently on the market or other situations

putting drug prices at risk for sky rocketing related to supply and demand. This law

requires the FDA to act within 180 days and push approvals of generics in these

categories to the top of their priority list (H.R. 749, 2017). This will prevent a large

increase in price and drug shortages on life-sustaining medications.

As Big Pharma spends millions of dollars lobbying against the lowering of

prescription drug costs, the American people need to lobby for lowering. Some ways we

as American people can do this is supporting and voting into office people who have this

issue as a top priority such as Kerri Evelyn Harris and Sen. Bernie Sanders. Voting is one

of the top ways Americans can use their voice. Another way is as groups, write to your

local senator and house of representatives about this issue to show this is what the people

want to see happen. As nurses, we see many examples of how this issue affects our

patients and sharing a story of how this has affected someone’s health without breaking

HIPPA law could be moving as well. Lowering prescription drug prices is in favor of

nurses and hospitals because it will improve patient outcomes, decrease repeat

admissions due to non-compliance of medications, and allow budgeting to allow for other

changes we want to see in the facilities now that we are paying an affordable price for

medications.
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On October 2nd, more than 700 hospital CEOs petitioned Congress in regards to a

lawsuit filed in September against the U.S. Department of Health and Human services

that would cut the 340B program by 1.6 billion dollars. This is not beneficial for hospital

CEOs and therefore, they took charge in numbers to make a change. Even more

impressive, a group of hospitals have come together to create a nonprofit drug

manufacturer company to battle other companies. Their goals include the creation of 14

generic drugs administered in hospitals and being nonprofit, their goals are simply supply

to the people at affordable rates (Cygan, 2018).

Our goals for lowering prescription drug prices have been discussed above, but

let’s reiterate what would lower the prices and keep them down. First, allowing

importation of drugs from countries such as Canada would lower the risk of shortages

and offer the same drugs at a discounted price. Of course there would be extensive

policies and regulations to this importation as to be sure these drugs are safe for our

people. This would involve hospitals and pharmacies ordering from FDA regulated sites

from Canada as well as patients could order their medications across the border as long as

they had a prescription from a doctor. Secondly, increasing the production and approvals

of generic drugs would avoid shortages and unfair prices of drugs related to the current

shortage or competition. A recent bill introduced by Sen. Grassley is in favor of generic

companies, requiring brand names to legally aid in production of generic drugs by

providing affordable samples and reducing their “pay for delay” charges when generic

companies take too long to create a drug provided from a brand name. These bills are yet

to be passed. Thirdly, allowing Medicare and Medicaid, who fund a good amount of

drugs across America to people who are not able to afford them, negotiate drug prices
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with pharmaceutical companies, taking complete control away from Big Pharma.

Furthermore, it is in the works that Secretary Alex Azar would be negotiating the prices

for Medicare and Medicaid (CMS) (Scott, 2019). Also, this saves us taxpayers’ money as

we are contributing to the Medicare/Medicaid funding. In order to achieve these goals,

this requires the several bills listed previously to be passed through to President Trump’s

desk and for him to approve it as well. In his presidential campaign as well as currently,

Trump has touched on this topic and the need to lower costs so we would hope he would

follow through when these bills reach his desk. Lastly, what could potentially lower

prescription drug costs is pharmaceutical companies being required to release prices of

drugs to the public for example when they air a commercial on T.V. This would create

the competition and negotiation of prices most of America functions on. The American

people will request certain brands or generic brands to the doctor during prescribing and

it will force the pharmaceutical companies to make prices affordable or they will have no

business. This has been an idea of Trump’s administration a part of the American Patients

First blueprint released in May 2018 (U.S. Department of Health and Human Services,

2018). With all of these bills and ideas successfully put in place it will definitely make a

difference on the prices the pharmaceutical companies will be charging.

The United States pays the highest prices of prescription drugs in the world. Not

only has this affected people financially, it has affected their physical health because

many people cannot afford their medications, take them as not prescribed to make them

last longer, and have made themselves sicker than they were in some cases. A need for

this change is bigger than ever with America still battling issues with health care

insurance, medical bills, and the expense of healthcare compared to other countries. On
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top of it all, pharmaceutical companies are charging as much as they want for

medications and making billions of dollars because the people are out of options. It is

important for nurses to be involved with the need for policy change because it is our field

of work and interrupts the way we give quality and ethical patient care.
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References

Cox, C., Kamal, R., & Jankiewicz, A. (2016, April 5). Recent trends in prescription

drugs. Retrieved from www.jamanetwork.com

Cygan, H. (2018, October 15). Nonprofit aims to reduce inflated prescription drug prices.

Retrieved from www.nurses.com

H. R.1776-Improving Access to Affordable Prescription Drugs Act. (2018). Retrieved

from www.congress.gov

H.R.749- Lower Drug Costs through Competition Act. (2017). Retrieved from

www.congress.gov

S.469-Affordable and Safe Prescription Drug Importation Act. (2018). Retrieved from

www.congress.gov

Scott, D. (2019, February 26). Congress is grilling big pharma CEOs. Here are 8 ideas

for bringing down drug prices. Retrieved from www.vox.com

U.S. Department of Health and Human Services. (2018, October 15). What you need to

know about putting drug prices in tv ads. Retrieved from www.hhs.gov