Leveling the playing field for the costs of life-sustaining prescription drugs

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As I travel across my district and meet with constituents, one of the issues I hear about most often is the high cost of prescription medications. It’s a growing problem, especially for seniors. A recent study by the Kaiser Family Foundation found that in the past year, 23 percent of seniors didn’t fill a prescription because of the high cost. This is especially troubling when the prescription is for a life-sustaining drug. Seniors should be spending their retirement years with their family enjoying retirement, not worrying about how they’re going to pay for outrageously priced drugs they need to live. 

The Kaiser Family Foundation’s sobering statistic demonstrates the devastating impact of the skyrocketing costs of life-sustaining prescription drugs in the U.S. As someone who’s been an insulin-dependent diabetic for 30 years, I’ve experienced this firsthand. Over the past decade, the price of insulin has increased 197 percent, and Medicare Part D spending on insulin has increased 840 percent, according to data from the Center for Disease Control and Prevention.  And this is largely a U.S. issue, as drug prices are much lower in other countries. For example, the cost of the 50 most popular brand-name diabetes medications to the Medicare program in my district are 4.9 times the cost in Australia, 3.6 times the cost in the United Kingdom, and 2.6 times the cost in Canada.

We can’t allow Big Pharma to continue taking advantage of seniors with exorbitant costs. That’s why I introduced H.R. 5309, the Life-Sustaining Prescription Drug Relief Act of 2019, which would lower the cost of life-sustaining prescription drugs for seniors and others on Medicare.  This legislation allows the secretary of Health and Human Services (HHS) to leverage the purchasing power of the federal government along with prescription drug pricing data from other developed nations to ensure seniors receive better pricing and are not price-gouged on life-sustaining medications.

H.R. 5309 begins by lifting the current legal ban preventing Medicare from negotiating with drug companies for better prescription drug prices. That part is key. It’s a precursor to setting up a process for the secretary of HHS to review the cost of life-sustaining prescription drugs for excessive pricing. When a drug price is determined to be excessive, HHS will negotiate with manufacturers, prescription drug plan sponsors, and Medicare Advantage organizations to collaboratively work together to lower the cost of these drugs for seniors. Excessive pricing is defined as exceeding 110 percent of the average prices for such drugs in five reference countries: Canada, UK, Germany, France, and Japan. Drug manufacturers who refuse to negotiate in good faith with Medicare would be penalized an amount equivalent to twice the “excess” profits on all U.S. sales of a particular drug.

Some would argue that drug companies should be able to charge any price because that’s just how the market works. But the data shows the market for many prescription drugs is broken, especially for life-sustaining medications. It’s time to level the playing field. I introduced this legislation because seniors who rely on life-sustaining drugs can’t simply vote with their wallet to fight back against price-gouging. We need to stand up for seniors and give Medicare the tools it needs to drive down the prices of life-sustaining drugs. American retirees are the population most vulnerable to high drug costs and deserve better than the Big Pharma status quo. This bill is a start, but more needs to be done to bring down the high costs of prescription drugs for all Americans. I look forward to working with my colleagues to get this legislation passed to help save lives and provide financial relief to those who need it most.

Lipinski is chairman of the House Transportation and Infrastructure Committee’s Subcommittee on Railroads, Pipelines and Hazardous Materials.

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