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My patient Gina, a retired nurse, suffered a brain injury while on a biking trip with family and friends. Once the life of the party, she now presents with cognitive impairment, major depression, and a very flat affect. We tried several medications to no avail. As a last resort, we decided on a new brand name drug, FDA-approved for depression, which changed her life and brought back her old vivacious self. Unfortunately, this medication was costing $300 for a 30-day supply. Gina is now off the medication, as she could not afford the drug costs along with her medical treatments. The bipartisan CREATES (Creating and Restoring Equal Access to Equivalent Samples) Act of 2018 (S. 974/H.R. 2212) could help save and restore her life.

pharmacy shelfs

Rising drug costs pose serious health challenges and create worsening health conditions, due to barriers in accessibility and affordability, in vulnerable populations such as geriatrics, people on disability, or communities afflicted with health disparities or economic hardship. In my 22 years of nursing, I have never experienced as drastic a rise in prescription drug costs as I do today. As an Advanced Practice Registered Nurse in Neuropsychiatry, my patient clientele consists of those suffering from chronic neurological disorders and diseases like Parkinson’s, Huntington’s disease, traumatic brain injuries, and those who present with mood and mental instability. It is very unfortunate that in addition to high treatment costs, my clients also have to bear the brunt of high drug costs. Medications that could possibly save their lives from suicide or psychosis are often not covered by their insurance, and the out-of-pocket costs can be exorbitant.

Americans spent over $457 billion for prescription drugs in 2015, and costs are expected to increase by $27 billion every year through 2025. Over 60 percent of Americans identified lowering the cost of prescription drugs as a “top priority” for the Trump administration and Congress in a 2017 poll. The American Patients First plan introduced in May 2018 identified four challenges in the American drug market, including: (1) high list prices for drugs; (2) seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; (3) high and rising out-of-pocket costs for consumers; and (4) foreign governments free-riding off of American investment in innovation.

However, conservatives argue that any measure that reduces drug company profits will reduce innovation. The US Patent Agency gives drug companies monopolies on the sales of new medications. Drug companies obtain extensions on marketing exclusivity by means of secondary patents on superficial characteristics, such as pill coatings or formulas for timed-release, even when the original patents have long expired. US drug manufacturers set their own prices. In countries like England, Canada, France, Israel, and other developed countries, providing excellent care at sustainably lower costs does not allow patent changing and long monopolies. There are price negotiations with the governments for both patent and generic formulations.

united states capitol

The bipartisan CREATES Act of 2018 (S. 974/H.R. 2212) would level the field in terms of costs, saving patients billions and increasing access to lower cost generic drugs. The Health and Human Services identifies strategies for reform by improving competition, holding better negotiations, creating incentives for lower list prices, and lowering out-of-pocket costs. This bill is co-sponsored by a broad bipartisan spectrum of members of Congress including both Senator Tammy Baldwin (D-WI) and Senator Ted Cruz (R-TX).

How long do we let patients like Gina be at the receiving end of these rising drug costs and worsen their health situations? Health care stakeholders should promote policies that preserve needed innovation and competition, while also promoting greater transparency to improve the value of prescription drugs for patients. We have to take a stance and fight for our patients and loved ones. We have to make our voices heard in Congress, by lobbying and speaking to our state, or even national representatives to VOTE YES on S. 974/H.R. 2212. It won’t be long before the impact of high drug costs starts taking the precious lives of our loved ones and patients, due to medication non-compliances and cost issues, and we are faced with the task of managing rising death tolls.

By: Maria Karandikar, MSN, ANP-C
Adult Nurse Practitioner – Raleigh

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