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Spokane, Washington  Est. May 19, 1883

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Drug pricing transparency is vital to addressing costs

By Dr. David Ward Kaiser Permanente Lincoln Heights Medical Center

I’m a physician because I care about my patients, my community, and using effective medicine to improve lives. Prescription medications are often central to the therapies I use to help my patients. But it is becoming harder and harder to practice medicine without acknowledging the impact that pharmaceutical corporations’ pricing decisions have on my patients.

Several patients in my practice have insulin-dependent type 2 diabetes. It boggles my mind that a medication that has been on the market so long is drastically rising in cost in just four years. Insulin treatment has been around since the 1920s – what changed all of a sudden to drive this new cost on a classic treatment option?

Diabetic patients are often on insulin for life. Many of these patients have already made pretty big financial changes to make sure they can pay for insurance coverage and their insulin, but the price is just skyrocketing. And patients who are senior citizens or disabled have fixed incomes and can’t easily absorb the price increases.

When insulin goes from $40 to $360, that money has to come from somewhere. For many patients there’s nowhere for that money to come from. Can you afford to have the grandkids over for dinner, or do you have to pay for insulin?

I also see patients who face trouble breathing due to asthma, allergies, or Chronic Obstructive Pulmonary Disease (COPD). I prescribe them albuterol, a rescue inhaler. I hear my patients tell me they’re rationing their inhaler or afraid to use it because of the cost, but this can result in life-threatening breathing problems or expensive trips to the Emergency Department.

The second and more devastating thing I see is these patients choosing the short-term rescue prescription over the long-term management prescription. When someone has asthma or COPD and they have a pattern of using a rescue inhaler, we need to put them on longer-acting medications that build up the strength of their lungs. With longer-acting medications, after two or three months they won’t need rescue inhalers. But to some of my patients, the longer-acting drug is so expensive that if they can’t afford both treatments, they don’t take the longer-acting one. Then the patient ends up in the ED because they can’t breathe. This results in a bad experience for the patient and a more expensive treatment.

As a physician, I need to be able to get the best medicine for my patients.

These and other drugs are getting so expensive that the change in cost is reflected in higher deductibles on medications and higher premiums for everyone. We all know the cost of health insurance is increasing; out-of-control prescription drug prices are a large driver of the cost.

At Kaiser Permanente, we help patients make cost-effective, evidence-based choices. As a team we can legitimately say, “This is the best drug for you and it’s cost effective without sacrificing quality.” Yet still our prescription drug costs at Kaiser Permanente Washington have gone up $70 million in two years. We are doing our part to encourage the best solutions but we can’t do it in a vacuum.

None of us understands why these prices are increasing. We are unable to hold drug companies accountable for their decisions made in secrecy. We are all downstream of their decisions, and every one of us – regardless of the prescriptions you have – is paying more for health care because of it.

That’s why I’m advocating for transparency around prescription drug prices. If we knew why drug costs are increasing, we could do something about it. It doesn’t solve the problem but it’s an important first step. Right now lawmakers in Olympia are considering bills that would do just that – Senate Bill 5292 and House Bill 1224 – making it possible for us to at least understand more about why this is happening.

We have a fantastic medical system in Spokane and nationwide. We are here to help you get well and stay well. But our system can’t help patients if it’s too expensive to access. We need to take steps to hold prescription drug corporations accountable for the decisions they’re making and the impact on every patient – because medications are only effective if patients can afford to get and use them.

Dr. David Ward is assistant physician in chief of Kaiser Permanente Lincoln Heights Medical Center in Spokane.