Doing What Washington Can't Seem to Do

North view of The White House

Remember when drug prices were on everyone’s mind?

Like last fall when the House of Representatives passed HR3, the Lower Drug Costs Now Act of 2019. Or earlier last year when the industry had to testify before Congress and reports of price-fixing by generic drugmakers first surfaced. Or in 2018 when the White House unveiled American Patients First, its blueprint for lowering prescription drug costs.

While everything took a backseat to the coronavirus in politics and the media, COVID-19 brought drug prices into more painful focus. We guarantee prescription prices are still on the minds of millions of Americans, even more so for those who have lost income or their health.

Now drug prices are in the news again. President Trump signed a series of Executive Orders on July 24, moves which echo both his 2018 blueprint and the House bill that, by most accounts, has no chance to clear the current Senate:

  • Help states, drug wholesalers and pharmacies import drugs from Canada
  • Tie prices that Medicare pays to what other countries pay
  • Give rebates intended for insurance middlemen directly to consumers

It’s great to see the issue at least on the middle burner again, even if these orders are political positioning ahead of an election. Unfortunately, their potential for impact seems minimal at best:

  • Many legal and health policy experts question the legality or reality of these orders going into effect or being enforced.
  • Canada opposes the importation measure and warned its domestic supply can’t handle demand from the U.S. market.
  • Drugmakers say the “international price index” or “favored nations” pricing is a nonstarter and show no signs of reaching a deal with the president by his Aug. 24 deadline.
  • As for rebates going directly to consumers… Well, we’ve all heard that before.

We’ve heard everything before. For years. And here we are, watching the same game unfold between the industry, Congress and the White House. The players and the plays may change, but the outcome is always the same: consumers lose.

More employers and health plans are saying enough is enough and deciding to partner with us, even during this time of economic distress. Because they know we can help their members and their plans.

We could throw all sorts of numbers at you on how much we’ve saved members and clients this year, but that would sound like a politician citing something out of the Congressional Budget Office. It’s all relative. Instead, here’s an everyday example that epitomizes both the need for our solution and the results.

A household name, Fortune 500 employer just launched in March. Within the first month, 42% of primary policyholders on maintenance medications had registered with us. One of them was on a regular medication to treat epilepsy at $276 for a 30-day fill—out of her pocket at the time, then on the client’s dime after her deductible was met.

Our clinical suggestions engine ID’d a dose-multiplying opportunity with the same exact drug—two 150 mg tablets in place of one 300 mg tablet. Cost difference: $257 per fill. The member saw our Savings Notification, logged into her portal, saw the savings potential, clicked “Contact My Prescriber,” and her doctor promptly approved the switch. Result: more than $3,000 in annualized savings for the member and the plan.

While Washington continues to posture and push relief down the road, we’re helping consumers and payers with a proven solution every day. What would you rather bank on for the next 4 years?