Rising Cost of Prescription Medications and Effective Management of Healthcare Costs in the United States
Keywords:
Prescription Costs, Medication, Healthcare Costs, United States, Cost Management.Abstract
In 1995, total US spending on healthcare was about $2.9 trillion, representing around 17% of 2013 GDP and a sharp increase from the 12% of GDP it represented in 1995. A large chunk of the healthcare spending was on pharmaceutical products, which represented about 2% of GDP in 2013. Many reasons have been expounded for why medications cost the highest in the United States compared to any other country. This paper aims to (a) Explore the reasons for this high cost and (b) Propose possible solutions to this problem.
References
[1] Charles G. Smith, James T. O'Donnell. The Process of New Drug Discovery and Development,Informa Healthcare, Second Edition,, 2006, p. 422.
[2] US Consumer Reports. “Are you paying more for your Rx needs?” Available: http://www.consumerreports.org/cro/news/2015/08/are-you-paying-more-for-your-meds/index.htm[Nov 2015]
[3] Anne B. Martin, Micah Hartman, Joseph Benson, Aaron Catlin and the National Health Expenditure Accounts Team. “National Health Spending In 2014: Faster Growth Driven By Coverage Expansion,”Health Affairs,,no. (2015) doi: 10.1377/hlthaff.2015.1194.
[4] OECD (2015), Health spending (indicator). doi: 10.1787/8643de7e-en [22 November 2015]
[5] Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington: National Academy Press, 2001.
[6] Davis K, Schoen C, Stremikis K. “Mirror on the wall: how the performance of the U.S. health care system compares internationally”, 2010 update. New York: Commonwealth Fund, 2010.
[7] William W. Chin, M.D. “A Delicate Balance — Pharmaceutical Innovation and Access,”N Engl J Med 2015; 373:1799-1801.
[8] Center for Medicare and Medicaid Services. “National health expenditures aggregate, per capita amounts, percent distribution, and average annual percent growth: selected calendar years 1960–2010” Available: https://www.cms.gov/NationalHealthExpendData/downloads/tables.pd
[9] Peters CP. “Fundamentals of the prescription drug market.” NHPF Background Paper. Washington DC: National Health Policy Forum; 2004. Available: http://www.nhpf.org/library/background-papers/BP_RxIndustry_08-24-04.pdf.
[10] The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts, Experts in Chronic Myeloid Leukemia Available: http://www.bloodjournal.org/content/121/22/4439.long?sso-checked=true
[11] IMS Institute for Healthcare Informatics. “Medicines use and spending shifts: A review of the use of medicines in the U.S. in 2014”. Parsippany (NJ): The Institute; 2015 Apr.
[12] Altarum Institute. Center for Sustainable Health Spending data brief: “A ten year projection of the prescription drug share of national health expenditures including nonretail”. Available: (http://altarum.org/sites/default/files/uploaded-publication-files/Non-Retail%20Rx%20Forecast%20Data% 20Brief_with%20Addendum.pfd, August 2015
[13] Ismail Kola, John Landis. “Can the Pharmaceutical Industry Reduce Attrition Rates?” Nature Reviews Drug Discovery, 2004 (3), 711–716.
[14] Roxanne Nelson, “Why Are Drug Costs So High in the United States?,”Medscape Medical News. Available: http://www.medscape.com/viewarticle/835182
[15] Donald W Light, Joel R Lexchin. “Pharmaceutical Research and Development: What Do We Get For All That Money?” BMJ 2012;345:e4348doi: http://dx.doi.org/10.1136/bmj.e4348
[16] Dean Baker, “Reducing waste with an Efficient Medicare Prescription Drug Benefit”,Center for Economic Policy and Research, Available: http://cepr.net/documents/publications/medicare-drug-2012-12.pdf, Issue Brief, January 2013
[17] Stewart DJ, Whitney SN, Kurzrock R(2010) “Equipoise lost: Ethics, costs, and the regulation of cancer clinical research” J Clin Oncol 28:2925–2935.
[18] Hagop M. Kantarjian,Tito Fojo, Michael Mathisen and Leonard A. Zwelling. “Cancer Drugs in the United States: Justum Pretium—The Just Price”, J Clin Oncol, 2013
[19] Peter Ubel, MD, “Do oncologists have an incentive to prescribe expensive treatments?,” Available: http://www.kevinmd.com/blog/2012/07/oncologists-incentive-prescribe-expensive-treatments.html [Nov 2015]
[20] Mary Pat Flaherty, Gilbert M. Gaul. “Millions of Americans Look Outside U.S. For Drugs” Washington Post, Oct. 23, 2003. Available: https://www.washingtonpost.com/archive/politics/2003/10/23/millions-of-americans-look-outside-us-for-drugs/8bfeb294-b1b2-4be5-bb4b-0764d1e899d3/
[21] Zullo, Andrew R.; Dore, David D.; Galárraga, Omar (March 2015). "Development and validation of an index to predict personal prescription drug importation by adults in the United States". Journal of Pharmaceutical Health Services Research 6 (1): 33–41.doi:10.1111/jphs.12088.
[22] Sreedhar Potarazu. “Rising cost of prescription drugs threatens health care gains.” August 2015 Available:http://www.cnn.com/2015/08/26/opinions/potarazu-drug-price-hikes/)
[23] ”NICE limits reimbursement for oncology products beyond EMA product labeling”. Context Matters. May 2014,Available:http://www.phrma.org/sites/default/files/pdf/context-matters-nice-restrictiveness-oncology.pdf
[24] Hillner BE, Smith TJ (2009) “Efficacy does not necessarily translate to cost effectiveness: A case study in the challenges associated with 21st-century cancer drug pricing.” J Clin Oncol 27:2111–2113
[25] Kaiser Commission on Medicaid and the Uninsured. Kaiser Family Foundation; “The uninsured and the difference health insurance makes”. 2012. Available from: http://www.kff.org/uninsured/upload/1420-14.pdf.
[26] Mojtabai R, Olfson M. “Medication costs, adherence, and health outcomes among Medicare beneficiaries”. Health Affairs. 2003;22(4):220–9
[27] Schoen C, Guterman S, Shih A, et al. “Bending the curve: options for achieving savings and improving value in U.S. health spending."The Commonwealth Fund, 2007
[28] Harvey V. Fineberg, M.D., Ph.D. “A Successful and Sustainable Health System — How to Get There from Here,”N Engl J Med 2012; 366:1020-1027March 15, 2012DOI: 10.1056/NEJMsa1114777
[2] US Consumer Reports. “Are you paying more for your Rx needs?” Available: http://www.consumerreports.org/cro/news/2015/08/are-you-paying-more-for-your-meds/index.htm[Nov 2015]
[3] Anne B. Martin, Micah Hartman, Joseph Benson, Aaron Catlin and the National Health Expenditure Accounts Team. “National Health Spending In 2014: Faster Growth Driven By Coverage Expansion,”Health Affairs,,no. (2015) doi: 10.1377/hlthaff.2015.1194.
[4] OECD (2015), Health spending (indicator). doi: 10.1787/8643de7e-en [22 November 2015]
[5] Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington: National Academy Press, 2001.
[6] Davis K, Schoen C, Stremikis K. “Mirror on the wall: how the performance of the U.S. health care system compares internationally”, 2010 update. New York: Commonwealth Fund, 2010.
[7] William W. Chin, M.D. “A Delicate Balance — Pharmaceutical Innovation and Access,”N Engl J Med 2015; 373:1799-1801.
[8] Center for Medicare and Medicaid Services. “National health expenditures aggregate, per capita amounts, percent distribution, and average annual percent growth: selected calendar years 1960–2010” Available: https://www.cms.gov/NationalHealthExpendData/downloads/tables.pd
[9] Peters CP. “Fundamentals of the prescription drug market.” NHPF Background Paper. Washington DC: National Health Policy Forum; 2004. Available: http://www.nhpf.org/library/background-papers/BP_RxIndustry_08-24-04.pdf.
[10] The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts, Experts in Chronic Myeloid Leukemia Available: http://www.bloodjournal.org/content/121/22/4439.long?sso-checked=true
[11] IMS Institute for Healthcare Informatics. “Medicines use and spending shifts: A review of the use of medicines in the U.S. in 2014”. Parsippany (NJ): The Institute; 2015 Apr.
[12] Altarum Institute. Center for Sustainable Health Spending data brief: “A ten year projection of the prescription drug share of national health expenditures including nonretail”. Available: (http://altarum.org/sites/default/files/uploaded-publication-files/Non-Retail%20Rx%20Forecast%20Data% 20Brief_with%20Addendum.pfd, August 2015
[13] Ismail Kola, John Landis. “Can the Pharmaceutical Industry Reduce Attrition Rates?” Nature Reviews Drug Discovery, 2004 (3), 711–716.
[14] Roxanne Nelson, “Why Are Drug Costs So High in the United States?,”Medscape Medical News. Available: http://www.medscape.com/viewarticle/835182
[15] Donald W Light, Joel R Lexchin. “Pharmaceutical Research and Development: What Do We Get For All That Money?” BMJ 2012;345:e4348doi: http://dx.doi.org/10.1136/bmj.e4348
[16] Dean Baker, “Reducing waste with an Efficient Medicare Prescription Drug Benefit”,Center for Economic Policy and Research, Available: http://cepr.net/documents/publications/medicare-drug-2012-12.pdf, Issue Brief, January 2013
[17] Stewart DJ, Whitney SN, Kurzrock R(2010) “Equipoise lost: Ethics, costs, and the regulation of cancer clinical research” J Clin Oncol 28:2925–2935.
[18] Hagop M. Kantarjian,Tito Fojo, Michael Mathisen and Leonard A. Zwelling. “Cancer Drugs in the United States: Justum Pretium—The Just Price”, J Clin Oncol, 2013
[19] Peter Ubel, MD, “Do oncologists have an incentive to prescribe expensive treatments?,” Available: http://www.kevinmd.com/blog/2012/07/oncologists-incentive-prescribe-expensive-treatments.html [Nov 2015]
[20] Mary Pat Flaherty, Gilbert M. Gaul. “Millions of Americans Look Outside U.S. For Drugs” Washington Post, Oct. 23, 2003. Available: https://www.washingtonpost.com/archive/politics/2003/10/23/millions-of-americans-look-outside-us-for-drugs/8bfeb294-b1b2-4be5-bb4b-0764d1e899d3/
[21] Zullo, Andrew R.; Dore, David D.; Galárraga, Omar (March 2015). "Development and validation of an index to predict personal prescription drug importation by adults in the United States". Journal of Pharmaceutical Health Services Research 6 (1): 33–41.doi:10.1111/jphs.12088.
[22] Sreedhar Potarazu. “Rising cost of prescription drugs threatens health care gains.” August 2015 Available:http://www.cnn.com/2015/08/26/opinions/potarazu-drug-price-hikes/)
[23] ”NICE limits reimbursement for oncology products beyond EMA product labeling”. Context Matters. May 2014,Available:http://www.phrma.org/sites/default/files/pdf/context-matters-nice-restrictiveness-oncology.pdf
[24] Hillner BE, Smith TJ (2009) “Efficacy does not necessarily translate to cost effectiveness: A case study in the challenges associated with 21st-century cancer drug pricing.” J Clin Oncol 27:2111–2113
[25] Kaiser Commission on Medicaid and the Uninsured. Kaiser Family Foundation; “The uninsured and the difference health insurance makes”. 2012. Available from: http://www.kff.org/uninsured/upload/1420-14.pdf.
[26] Mojtabai R, Olfson M. “Medication costs, adherence, and health outcomes among Medicare beneficiaries”. Health Affairs. 2003;22(4):220–9
[27] Schoen C, Guterman S, Shih A, et al. “Bending the curve: options for achieving savings and improving value in U.S. health spending."The Commonwealth Fund, 2007
[28] Harvey V. Fineberg, M.D., Ph.D. “A Successful and Sustainable Health System — How to Get There from Here,”N Engl J Med 2012; 366:1020-1027March 15, 2012DOI: 10.1056/NEJMsa1114777
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2016-01-01
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Tijani-Eniola, O. (2016). Rising Cost of Prescription Medications and Effective Management of Healthcare Costs in the United States. American Scientific Research Journal for Engineering, Technology, and Sciences, 15(1), 88–95. Retrieved from https://asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/1224
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