Massachusetts Medical Society: Prescription Drug Pricing

Prescription Drug Pricing

Drug Price


THE ISSUE:

Medications are an essential part of our health care system for prevention and treatment of almost all health conditions. Over time, the costs of prescription drugs have skyrocketed, affecting patients and health care systems. The U.S. spends hundreds of billions of dollars a year on prescription drugs.  

Expensive medications drastically impact patient welfare. High and rising costs of prescription drugs impede the ability of physicians to provide the best quality of medical care possible to patients. High costs for prescription drugs can lead patients to forgo important, prescribed drugs from their doctors. Decreased access and medication rationing lead to dangerous health outcomes and for some conditions, such as diabetes or anaphylaxis, can even lead to death. The COVID-19 pandemic has made clearer the importance of access to affordable medications—from inhalers to insulin—to protect those with chronic conditions at highest risk for complications from the virus.

OUR STANCE:

Medications are prescribed to improve and save patient lives and the Massachusetts Medical Society believes prescription drugs should be affordable and available to patients without undue burdens.

The MMS supports:

  • Drug price transparency for health care providers and patients
  • Patient protections regarding excessive drug pricing
  • Eliminating the Medicare prohibition on drug price negotiation
  • Banning direct-to-consumer drug ads in Massachusetts
  • Creating a national database listing medication prices and out-of-pocket costs
  • Advocacy to the Federal Trade Commission to limit anti-competitive behavior by pharmaceutical companies
  • State oversight of pharmacy benefits managers (PBMs) through licensure and required submission of data and other information to appropriate state agencies

CURRENT ADVOCACY:

  • The Massachusetts Medical Society is part of the Massachusetts Prescription Drug Affordability Coalition, formed to support legislative efforts to make prescription drugs affordable and available to patients, make pharmaceutical costs are more transparent and affordable for the health care system, and ensure the pharmaceutical industry does their fair share to control health care costs.
  • Through our Prescription Drug Affordability Coalition, MMS was part of a successful effort to adopt provisions in the FY20 state budget that address rising prescription drug costs in the MassHealth program. This new law provides the MassHealth program with new tools to incentivize pharmaceutical manufacturers to come to the table to negotiate additional supplemental rebates for certain excessively priced drugs, which will achieve critical savings for the state and ultimately, patients. According to the Baker Administration, in its first year of implementation this program has saved the state Medicaid plan $91 million in gross savings for 32 drugs.
  • Additionally, MMS supports prescription drug policies addressing the needs of individuals at risk for COVID-19 due to chronic conditions, which disproportionately affect communities of color and low-income communities. Such measures include, for example, establishing a program to reduce cost-sharing for medications treating chronic conditions that are risk factors for COVID-19 complications, and for FDA approved COVID-19 vaccines and medications. 

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