How are we to help our most vulnerable neighbors—the un- or under-insured, the elderly, and children—when they have chronic illnesses? What can we do to help them get the prescription medications they need when the cost is often beyond their ability to pay?
Take for instance, the cost of the cancer drug Bavencio: a three months’ supply costs around $27,000. The cost of insulin tripled between 2002 and 2013, despite no significant changes in the formula or manufacturing process. And recently, the EpiPen caused national public outrage over its price hike of 500% since the year 2007. For those with asthma, inhalers are truly life-saving. The average price for the inhaler Advair, increased by 56% from 2013 to 2018. The average cost for the Flovent inhaler increased 41% in the same time period.
Imagine being that asthma patient’s parent, caregiver, or spouse and the unenviable choices such high prices are likely to force upon him or her.
“People are concerned about drug prices;” says Leigh Purvis, director of health services research for the AARP Public Policy Institute. “More are being forced to make trade-offs between paying for their drugs and for food or rent.”
How does this happen?
Those who are uninsured are usually required to pay the full retail price at the pharmacy counter, and the underinsured—those who have some kind of health insurance (but not enough)—end up paying the full cost of drugs during their deductible periods. After the deductible period is over, the copayments are often still out of reach.
While AARP focuses on the senior population, the same barriers for the elderly are rising up for other minorities. The National Center for Biotechnology Information, a branch of the National Institutes of Health, is looking at the effects of high prescription costs on African-Americans and Hispanics. Certain chronic conditions such as hypertension and type 2 diabetes are more prevalent in this demographic, and the drugs that treat them are often the most expensive part of their care. It’s an alarming paradox that while minorities are more likely to suffer from conditions that require sustained pharmaceutical intervention, they often can’t afford to take the drugs that help manage those conditions.
What can be done to help bridge this gap?
One interesting finding from the NIH study revealed that minorities had significantly lower levels of communication with their physicians when it came to the costs of medications than their white counterparts. Better training and more awareness within the medical community can help: physicians are in the unique position of being face-to-face with their patients and can talk openly with them about drug costs; insurance providers can help patients implement strategies for paying for their medications on an on-going basis.
Interestingly, there is a trend among African-Americans and Hispanics that can shed light on how to help them manage costs. Minorities rely more heavily on their phone for internet access, according to a recent Pew Research Center report. Some 13% of Hispanics and 12% of African-Americans are smartphone-dependent, meaning they don’t have a broadband connection at home, and nearly three-quarters (73%) of Hispanic smartphone owners used their phone in the past year to research a health condition, which is similar to the share for African-Americans. This then, is another area where the health-care community can educate this demographic on how to manage the costs of prescription medications and set up payment plans.
Another strategy is accessing a service like Nova Scripts Compass. Patients and caregivers can go to the website, enter their zip code and search for free or reduced-cost services for medical care as well as food, housing and other necessities. Compass works by connecting those needing services with the agencies and organizations that can help them.
The complex web of pricing pharmaceuticals, from research and development to the basic structure of how the industry operates is not easy to understand. But for our under-served neighbors needing affordable medications, there just might be a few answers very close by—their doctors and nurses, their cell phones, and agencies willing to help.