What Patients and Doctors Can Do About the Rising Cost of Medicine

Americans spend more than anyone else in the world on prescription drugs. The average person in the United States spends $1,200 each year on medication alone. If that person has a medical condition, you can expect that number to increase dramatically. 

Because of this, almost 50% of Americans have trouble paying for their prescriptions and many aren’t following through with the correct treatment. To help manage the cost, many patients are not taking their medicine as directed. Some of them take less of the medication to conserve it and make the prescription last longer. Others do not take their medication at all. In fact, around 30% of all prescriptions are never filled. However, the cost of not taking your medicine can be even larger than the financial stress of paying for them. 

There are a number of reasons the cost of medicine is rising and it’s important to know how doctors and patients can both take action to combat the issue.

Why is the Cost of Medicine Rising?

There are three key players in the rise in the cost of medicine: drug manufacturers, insurers, and pharmacies.

It all begins in manufacturing. For example, due to the high demand of patients requiring hepatitis treatment, the manufacturer has no incentive to reduce the price for consumers. The cost of a full treatment runs around $84,000.

Another costly treatment is cancer. The cost of cancer treatment is astronomical and can be out of reach even for those with insurance. Just before 2000, cancer treatment cost around $10,000 for a full treatment. By 2012, this price increased to $100,000. With so many people suffering from cancer, why would the manufacturer increase their pricing? 

Additionally, health insurance plans cost more to cover the price of these medications, whether you are a user of a specific drug or not, which means higher costs for everyone. Finally, the pharmacies add additional costs so that they can make money too.

Some of the biggest examples in medicine where these price hikes can be seen are for diabetes treatments and the prices of EpiPens. Both medications are necessary and lifesaving for those who need them. Without them, the patient can die. However, the price of an EpiPen prescription has risen 500% in 10 years. For patients in need of insulin to keep their blood sugar in check, insulin has become wildly overpriced as well. In some cases, a single vial of insulin can cost as much as $362, which makes thorough comparisons of brands necessary

Name-brand drugs have not been the only medications that have seen increases. Generic drug prices have been rising as well. These increases have outpaced inflation over the years, making it nearly impossible for patients to afford medicine — never mind the cost of healthcare on top of it. 

Over the past decade, insurance companies have been placing more of the responsibility of paying for medication on the patients. The consumer is now responsible for somewhere between 25 and 80% of the cost.

What Doctors Are Doing to Help

While the outlook may seem bleak, there are things physicians can do to help lower the cost of medication for patients. Doctors can consider prescribing generic drugs instead of name-brand medicines to help control the cost for their patients. As mentioned above, though, this won’t always help control cost. Many generic medicines have risen in cost as well. 

One of the best things doctors can do is help educate their patients. Where insulin is concerned, for example, many patients aren’t aware that no prescription is required. You can get insulin anywhere in the world without one. You can also cut the cost of the medication when you buy it from somewhere like Walmart versus CVS or a small pharmacy. 

Communication between doctors and patients about information like this is crucial in combating the rising medication costs. It is also important for them to discuss the entire treatment process and the cost with them ahead of time. Doing this can help the patient prepare themselves, mentally and financially. 

The way physicians are trained can have an impact as well. As medical students and as professionals, they should never participate in free lunches or accept any gifts from pharmaceutical representatives and other for-profit medical equipment sellers that may impact their ability to make a decision that is best for their patients. 

In some cases, pharmaceutical companies will pay doctors to send patients their way and offer sponsored activities and lunches within hospitals and other medical centers. Avoiding these and not accepting these gifts should be taught in medical school to ensure an ethical standard is set. If doctors don’t allow themselves to fall victim to such antics, they can provide patients with the best affordable care. 

M.D.s aren’t the only ones who can make a difference, either. Registered nurses with a Doctor of Nurse Practicing (DNP) can have an influence on policy, which in turn can change the cost of medicine as well. RNs who have received their doctorate are able to serve on boards and have more influence in battling things like the rising cost of prescriptions. 

The battle against the high cost of medication continues to be one of the greatest challenges facing the healthcare industry. And for now, it seems there is no real way to win with pharmaceutical companies. It is more important for physicians and nurses to focus on communicating with patients about their options. 

How Patients Can Help Lower the Cost

There are a number of things that can be done by patients to help lower the cost of their prescriptions. They may consider using a prescription savings card. Many doctor’s offices also have assistance programs available and will have information about how you can save on your medicine. 

It is always a good idea to shop around when it comes to medication as well. Don’t simply have them fill your prescription for you at the closest pharmacy. More than likely, the doctor’s office has some kind of partnership with them to send patients their way. Instead, ask for the written prescription and call around to see how much it costs in different places. 

If necessary, you can also appeal to your insurance coverage. When your insurer won’t cover enough of your medication, you can file an appeal and see about getting additional financial assistance from the insurance company. Your doctor can provide more information about how. 
No matter how it is done, the overwhelming cost of medicine is putting lives in danger. Whether it is causing financial stress or the patient decides they simply can’t buy their medication, the rising cost is threatening the lives of millions. Doctors and patients are not without hope, though. If they can band together, they can make a change in policy and help combat the predatory and unethical actions of drug manufacturers, insurers, and pharmacy companies. 

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