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Testimony on the Rising Cost of Prescription Drugs

October 27, 2020

On October 6th, PHAN was given the opportunity to testify in front of the House Republican Policy Committee about the importance of lowering prescription drug costs. This is Patrick Keenan and Shirley Johnson’s testimony:

Good afternoon Representative Puskaric and members of the committee. Thank you for highlighting the very real problem that too many Pennsylvanians are unable to afford the medications they need. Our organization is on the frontlines of this crisis. Each year, we answer nearly 10,000 calls and regularly engage consumers from 61 of Pennsylvania’s 67 counties. Over the past several years, we have noted an alarming trend that more and more people, including seniors, are choosing between their medications and necessities like food, housing, and utilities.

We were fortunate to partner with Altarum’s Healthcare Value Hub, through the support of the Robert Wood Johnson Foundation, to conduct the first-ever Pennsylvania-specific survey of healthcare affordability in late 2018. We hope to repeat this survey in the near future. We captured data representing all Pennsylvania adults across insurance types and have been able to generate regional reports for five parts of the state. It comes as no surprise that half of Pennsylvania adults told us they personally struggled with the costs of healthcare in the last year. This means they struggled to pay bills, went uninsured due to high premium costs, or failed to get the care they needed due to costs. For a majority of Pennsylvanians, some part of our current system did not work for them in the past year, jeopardizing their health, financial stability, employability, or family life.

Prescription drug costs were a main driver of affordability burdens, and while the problem is prevalent across the state, it is most pronounced here in the Southwest, with more respondents than anywhere else in the Commonwealth stating that they have had trouble with prescription drug costs.

  • 1 in 4 adults in the Southwest did not fill a prescription due to cost
  • 1 in 5 adults in the Southwest cut pills in half or skipped doses
  • 30% of adults in the Southwest either did not fill a prescription, cut pills in half, or skipped a dose, 6 points higher than the statewide number.

When hardworking families and seniors struggle to pay for prescription drugs and other healthcare costs, it not only affects their physical health but also their financial well-being:

  • 15% of Pennsylvania adults have been contacted by a collection agency in the last year
  • 12% used up all or most of their savings.
  • 10% were unable to pay for basic necessities like food, heat, or housing
  • 7 to 8% either racked up large amounts of credit card debt or borrowed money

Given these numbers, it’s no surprise that 9 out of 10 adults, across party lines, support a broad array of solutions to the problem of prescription drug costs. Specifically, on prescription drugs, with overall support at 90%, 88% of Republicans, 92% of Democrats, and 89% of Independents said the government should require drug companies to provide advance notice of price increases and justify those increases. Similarly, with overall support at 88%, 86% of Republicans, 91% of Democrats, and 86% of Independents said the government should set standard prices for drugs to make them affordable. In fact, here in the Southwest, support for advance notice and justification of price hikes is the highest in the commonwealth at 93%, and, likewise, the Southwest, at 92%, supports setting standard prices for drugs to make them affordable. While all residents of the commonwealth want decisive action, support is highest here in the Southwest from your own constituents.

While there is broad agreement at the federal level – including by the President and his administration – on the need to address out-of-control prescription drug costs, states have a significant role to play. We know that prescription drug prices are high and rapidly increasing, and this has had devastating consequences on our residents. The fact is that we cannot answer why those prices are rising. Texas last year passed one of the most comprehensive transparency laws in the country. It joins states like Maine, Nevada, Oregon, and Louisiana that have similar measures. Transparency gives us critical information from the manufacturers of pharmaceuticals that allows us to examine cost drivers and avoid speculation. It pulls back the curtain on questionable practices and abuse. Pennsylvanians deserve to know why their drugs cost so much, and this is analogous to what we already do in insurance, hospitals, and public utilities. We want to acknowledge the strong work Representative Puskaric has put forward in a bipartisan manner by introducing House Bill 2426, which would directly answer these questions.

While much of what I have said has been focused on the individual health and financial well-being of your constituents, we cannot forget that these individuals are also taxpayers and deserve accountability for and oversight on public spending as well. House Bill 2426 would allow Pennsylvania to engage in informed and fiscally responsible decision making. It is commonly acknowledged that the United States pays more for the same pharmaceuticals than any other country in the world, and this puts enormous strain on our state budget as well as local purchasers like counties and hospitals. Drug costs also hurt local businesses and employers as they struggle with rising premiums, increases which are often largely attributed to the rising costs of prescription drugs. Pharmaceutical manufacturers often hide behind claims that research and development drive costs, yet, as we have all seen recently, taxpayer dollars underwrite a substantial portion of these costs. What is often left is excessive and rampant abuse of pricing tactics to drive up stock prices. Simply, “Big Pharma” has earned its name because no one has the market tools necessary to respond to its monopolistic price setting, which is geared toward Wall Street and not Main Street.  Pennsylvania needs new tools at its disposal to investigate and respond to high & rising prescription drug costs. Our commonwealth, its hospitals, its health plans, its employers, and certainly its constituents deserve answers – and action.

Because the work of state government should be squarely centered on the people, we should close today by hearing from Shirley Johnson. She is from Allegheny County and has worked all her life to put food on her table and provide for herself in her older years. I’ll let her own words be the last here, and please allow me to first express our gratitude for the time you have given us today. Shirley:

My name is Shirley Johnson. I’m grateful to be here to share my experience with the high cost of prescription medicine. I’m 74 years old and I’ve lived in Pennsylvania my whole life. I take medications for asthma and COPD, which I need to breathe and which can be very expensive.

I was diagnosed with COPD. I also have asthma. Both diseases cause me to be short of breath when doing routine activities. And, during a particularly bad spell can cause my throat to close, which is frightening. My doctor has been very helpful. He first prescribed me Cymbacort, but we found out that it did not work well and led to unpleasant side effects. He moved me to Trelegy, which worked great. It worked for the entire day so I was able to avoid using my nebulizer, which causes me to shake badly and feel anxious. When we were trying out these medications, my doctor was able to get me samples. When we decided to go with the Trelegy, I got a prescription.  That’s when I found out that my Part D plan didn’t cover it and that if I wanted to use it, it would cost me $600 – that’s with a coupon from GoodRx. The doctor tried to help me get Treglegy through the company that makes it, but they wouldn’t help because I’m over 65. I was out of options, so I had to give up the medicine that my doctor and I knew worked the best for me.

After that, I tried Spiriva, which doesn’t work as well as the Treglegy. I’m using it now, but I can get out of breath just by climbing stairs or bringing groceries in from the car. I can’t use more than two puffs of Spiriva a day, so I’m forced to use my nebulizer, which leads to the shaking and anxiety. As a result, I only use it when my symptoms are so bad that I have no choice. This pattern keeps me from being able to do the normal activities I was capable of doing with the right medicine. The Spiriva also came with cost problems. When I picked it up the first time, it cost me over $200 because I had not met my deductible. When January comes, I’ll be faced with the deductible and the high costs of my medication all over again.

It’s not only my breathing medications that are priced out of my budget. About six months ago, I had pink eye. As you know, it’s easily treatable but without medicine, it can lead to blindness. I went to the doctor to get a prescription right away. When I went to pick up the antibiotic drops, I had to leave them behind because a tiny vial of drops cost $160. I didn’t know what I’d do. I was hoping that my kids might pitch in to help me out. When I mentioned the cost of the drops to my daughter, she told me that my grandson had recently had pink eye and that some of the drops were leftover. They hadn’t expired so I used them. Luckily the pinkeye was cured. I’m lucky my daughter had the right drops in her home. I’m lucky my kids are generous and would have helped me. But nobody should have to risk going blind from a simple infection because the medicine to treat is not affordable.

I’m on a fixed income. I have worked all my life, from my childhood on my family’s dairy farm to jobs in manufacturing and other industries. I’ve worked and paid into Medicare, so it should work for me now. That’s why I’m grateful to Rep. Puskaric for holding this hearing today. Something needs to be done, and soon.  The legislature should work to lower drug prices.  Seniors like myself can’t wait much longer. Thank you.