The average price of brand-name prescription drugs rose almost 130 times faster than inflation in 2015 — 15.5 percent compared with 0.1 percent. New data points to increasing medication affordability problems for older adults, putting many of them at risk, according to a new report.
Researchers from the AARP Public Policy Institute studied trends in the retail prices of 268 brand name drugs widely used by older Americans between 2006 and 2015. They found that the average annual cost of one name-brand drug is now more than $5,800 per year, an increase of $1,000 from 2014, and a $5,000 jump from 2006 costs. Older adults take an average 4.5 prescriptions annually, spending about $26,000 on medication for conditions such as heart disease, arthritis and diabetes. According to the report, prescriptions cost more than the average median income of $24,150 for Medicare beneficiaries.
“It’s kind of amazing,” said co-author Leigh Purvis, AARP’s director of health services research. Despite the attention given to rising drug prices, pharmaceutical manufacturers are conducting business as usual and setting their own prices, she said in a phone interview. “We’re increasingly concerned that many people can’t afford their needed drugs and aren’t getting the therapy they need.”
The affordability crisis often forces older adults to choose between food and medicine. Those who cannot afford medication to manage serious chronic conditions can cost the health system more in the long term is their condition worsens. It’s $330 billion problem in the United States, as this MarketWatch story explained. According to this Johns Hopkins analysis, the majority of the costs attributed to medication nonadherence result from avoidable hospitalization, as well as increased use of emergency departments, nursing homes, and avoidable pharmacy costs because comorbid conditions develop. At least 10 percent of hospitalizations of older adults are linked to medication nonadherence, the study estimates.
This story in The Atlantic looked at the real cost to consumers of nonadherence.
AARP’s report found that retail prices increased by 97 percent of the drugs in their analysis. And one anti-anxiety drug, Atavan 1mg tablets, rose 2,873 percent between 2006 and 2015. Atavan is marketed by Valeant Pharmaceuticals, which manufactures five of the six drugs with the highest cumulative increase over that period.
Even for older adults who can afford their medications, high copays, out of pocket costs, deductibles and other cost-sharing become a struggle, according to Purvis. The Wall Street Journal recently took a closer look at this angle.
AARP is working to lower prescription medication prices, Purvis said. It supports legislation such as the Fair Trade Drug Pricing Act, which would require a pharmaceutical company to report to the U.S. Department of Health and Human Services (HHS) when it raises a drug’s price by more than 10 percent during a year.
While there are many positive aspects to the recently-signed 21st Century Cures Act, Purvis has strong reservations about provisions concerning new drug and device approvals. “Fast tracking and deregulation are concerns because older adults are vastly underrepresented in clinical trials,” she said. Many drugs act differently in older adults, and since so many of them take multiple prescriptions, it’s not yet clear how the issue of efficacy in older patients will be addressed. (The bipartisan bill was signed into law by President Obama on Dec. 13).
There’s also concern over how Congress will address drug pricing in the coming years. Even lawmakers who have been resistant to tackling this issue are beginning to pay closer attention, Purvis said. “I don’t know if there is a choice in the matter. We’ve reached a tipping point when patients can no longer afford their medication.”
As more older adults transition into Medicare, or find themselves tapping into Medicaid, some experts predict the problem will get worse before it gets better. Journalists covering this issue may want to talk to their state legislators about Medicaid-related drug pricing, programs that help older adults afford their medication, and local or state efforts to support medication adherence.