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Does the Biden Administration Have a Plan to Combat Prescription Drug Prices?

March 9, 2021

high drug prices

Prescription drug prices in the United States have been increasing for decades now. Based on data from the American Association of Retired Persons (AARP), the average annual price of widely used prescription drugs increased by an astonishing 208% between 2006 and 2016. The average annual price went from $4,202 to $12,951 during that time frame.

The upward trajectory of retail prices for prescription medications are a known problem. In fact, they've been a known problem for many years. At this point, prescription medications account for about 10% of every healthcare dollar spent. And regardless of which party controls the government, nothing seems to be providing relief for the average American citizen.

Of course, this begs the question: Does the Biden administration have a plan to combat prescription drug prices? Or will it fall flat, just like every other "plan" put in place by his predecessors?

Here's what we know about the Biden-Harris plan moving forward.

What is Biden's Plan to Combat Prescription Drug Prices?

At this point, anything that the Biden administration does regarding prescription drug prices is conjecture. It's still very early in his presidency, and so this article will be based on Biden's plans more than his actions. We can't know for sure what he will try to do, or what he will be able to get done.

What we do know is that the administration is looking into their options. They clearly know prescription drug prices are a major problem for millions of Americans. Based on public statements and ones from insiders, we can hypothesize that the Biden administration has a few angles they could take.

Loosening Negotiation Restrictions

One possible way that the Biden administration is rumored to be researching lowering prescription prices is removing the no-negotiation rule for Medicare Part D coverage. Established in 2006, Medicare Part D is a supplemental Medicare plan that specifically covers prescription drugs. It's entirely separate from taxpayer-funded Medicare Part A (hospitalization), as well as supplemental plans known as Medicare Part B (doctor's visits).

The way current law stands, Medicare Part D isn't allowed to negotiate with pharmaceutical companies for lower prices on behalf of their enrollees. One would think that negotiation should be the norm, considering that people enrolled in Medicare Part D plans are typically retired and on a fixed income.

There are two major issues with this idea, which likely contribute to the reason why it hasn't been attempted by the current administration, nor the previous two. First of all, it's difficult to tell if it would actually benefit enrollees — ultimately, how tough the negotiators are would determine the benefit to consumers. If they are political appointees, their effectiveness could potentially fluctuate between administrations.

The other problem is that the logistics of lifting negotiation restrictions could be tricky. Would an Executive Order suffice? Or would that action need to go through Congress? It's not a simple answer, but constitutional lawyers and administration officials are undoubtedly looking into it.

What the administration might be able to do is put a cap on "launch prices of all branded, biologic, and 'abusively priced generic drugs'" based on their average cost in other countries. This would not affect existing drugs, but would be a step forward nonetheless.

Significant questions still remain whether any promises made to date by the administration are serious or just the sort of empty political posturing that Americans have seen from both Democrats and Republicans in the past with bipartisan kowtowing to the pharmaceutical industry behind the scenes.

Working with Congress

Many experts believe that the Biden administration will take the long and arduous route by collaborating with Congress to amend Medicare Part D. While this method would be much slower, working with members of Congress — who have been colleagues of both President Biden and Vice President Harris — could be more effective in the long run.

Two bills designed to address prescription drug prices have already been introduced, one of which is in the House, while the other is in the Senate. H.R.3 (Lower Drug Costs Now Act) was introduced by Speaker Pelosi (D-CA), and S.2543 (Prescription Drug Pricing Reduction Act) is bipartisan legislation sponsored by Senators Grassley (R-IA) and Wyden (D-OR).

Both bills propose a lower out-of-pocket spending cap for Medicare Part D enrollees, would shift responsibility for catastrophic costs onto insurers, and keep price increases below the consumer price index. If prices increase at a rate higher than inflation, insurers would be required to pay rebates to Medicare as a penalty.

H.R.3 aims to put a cap on brand, biologic, and "abusively priced generic drugs," but doesn't stop at launch prices, which may be something other lawmakers (as well as the President) take issue with.

The fact that there is at least on the surface bipartisan support for reducing prescription drug prices, and that a bill has already been introduced, increases the chances of change actually happening — especially since President Biden seems willing to work with Congress. In fact, some lawmakers are actually counting on a "push" from the president.

Of course, none of this is a guarantee, as the Senate is very divided in terms of party, with 48 Democrats, 50 Republicans, and 2 Independents. However, in the case of a tie vote, Vice President Harris would undoubtedly vote with the Democrats.

Prescription Drug Price Transparency

One thing that most administrations tend to agree upon is the desire for transparency in prescription drug prices.

In line with nearly every other political ideology (across the world — not just the U.S.), the major issue here is that while different parties might have the same goal, the way in which they choose to accomplish that goal may not be the same. They may not even be in the same ballpark.

Where some political parties will want to create regulations requiring companies to release their retail prices (and any changes to those prices), others might want to strongly encourage them to do so.

One of the final things the Trump administration did before the Biden Inauguration was to sign a rule they called Transparency in Coverage. This rule requires insurers to disclose the price of medication — not just current prices, but historical prices, as well. Additionally, insurers are required to provide personalized cost-sharing information to each enrollee.

For example, let's say that your Advair Diskus inhaler for asthma cost the insurance company $150.00 and they were charging you $25.00. This leaves their portion set at about $125.00, and they would be required to relay that information to you, the insured.

This might seem easy enough, since in most other industries, there is a set retail price that consumers can expect to pay. But in healthcare, this isn't the case at all. Finding the actual retail price of an insured drug is nearly impossible, and if you research prices at five different pharmacies, you're likely to find five different prices.

Unsurprisingly, pharmacy benefit managers (PBMs) and insurers are trying to fight this rule.

Consumer Choice

One of the "perks" of having a consumer-driven insurance model (meaning that people can choose their insurance plan, where they purchase their medications, and sometimes which medications they take) is that people supposedly have more control of their healthcare decisions. While this may be true in theory, this model tends to fail without price transparency.

For example, if you're trying to choose between a high deductible health plan (HDHP) and a more traditional premium-plus-copay model, it would be difficult to tabulate your expected medical and prescription expenses without knowing what each of those things costs. How much does it cost to give birth to a child? How much does your Xarelto cost per month after factoring in the insurance covered portion of the drug? These are valid questions with complex answers.

The truth is that price transparency is a problem throughout the American healthcare system. Prescription drug prices are only one facet of this problem, so even as prices become more transparent, there are still plenty of areas in which this philosophy needs to filter.

Looking For Relief from High Prescription Drug Prices

Regardless of the inordinate burden on consumers, the likelihood of relief coming anytime soon is quite low. The law moves slowly, and the higher up in the government it goes, the slower it moves. Even if Congress is able to come to a consensus (which is entirely possible), it will be quite some time before the effects are felt by the average consumer.

In fact, it's very possible that other healthcare issues will take precedence over prescription drug prices, particularly with the pandemic still thriving in the U.S. and the unknown long-term effects this virus will have on those affected. Not to mention the epic lobbying one can expect from Big Pharma to fight lower prescription drug costs.

And then of course, there's also the possibility that negotiations between Congress and the administration will stall out over fear that regulation will stifle innovation — especially when vaccines are so highly sought after at the moment. The concern here is that lower prices would equal lower profits, which would result in less investment in new drugs, treatments, and vaccines.

All that being said, there are certainly ways drug companies could increase their profits without increasing prices. For example, they could reduce their C-level executives' salaries and put those savings into research and development. But of course, these are for-profit companies beholden to stockholders, and matters like that are never simple.

Getting Started with an Online Canadian Pharmacy

The good news is that in the meantime, there are ways for you to decrease your prescription drug costs, and that's through international online pharmacies. Online pharmacies like NorthWestPharmacy.com are able to get lower prices for your medications because they source medications from countries with government-mandated price restrictions. You can buy Canadian drugs online for much less than you are likely paying right now or buy prescription drugs sourced through other countries from pharmacies that are part of our trusted and vetted supply network.

Most industrialized countries have systems in place to keep prescription prices within reasonable levels. This occurs during government negotiations with drug manufacturers and through regulation of drug prices.

However, the United States has maintained a hands-off approach, which has allowed manufacturers to basically charge whatever they want. Because we source our medications through Canada, Europe, and other countries where the prices are lower, we're able to get you a lower price.

In order to purchase medication through any CIPA-certified online pharmacy, you must have a valid prescription and a licensed pharmacist on hand to check it against your other prescriptions, just like a pharmacist in the U.S. would do.

Oh, and it's delivered straight to your door.

If you've never ordered a prescription through an international or online Canadian pharmacy, or want to make a switch to us, we'd love to help you through the process. It's natural to feel a bit anxious when you're ordering for the first time — we were all there once. We're very cognizant of this fact, and therefore have put a significant amount of time and effort into training our call center team members so they know how to help anyone and everyone who calls.

We take a lot of pride in our customer service, not just through our call center, but through the rest of our website and operations as well. We have compiled a wealth of information, such as step-by-step how-to-order instructions, frequently asked questions, and special feature articles that dig deeper into specific medications and healthcare issues.

We truly believe that we're the best online pharmacy on the internet, and we don't say that lightly. We work very hard to find you the lowest price (guaranteed, or we'll beat it) and provide helpful customer service.

If you're interested in placing an order or are confused about any portion of the process, don't be afraid to get in touch with us today. You're welcome to call our toll-free number (we're available every day of the week) at 1-866-539-5330. If you're calling outside of normal business hours, you can always email us. We'll get back to you very quickly.

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