The fact that prices for prescription drugs are constantly rising and become unaffordable presents a pressing concern in the United States. The government has attempted to address this issue in the majority of states via elaborating and implementing appropriate legislation. As for Florida, Prescription Drug Pricing Transparency House Bill 351 was introduced in this area. It requires pharmacists “to inform customers of generically equivalent drug products, as well as to advise customers on whether the associated cost-sharing exceeds that for prescribed drugs” (Pope, 2018, p. 8). This law is considered to have a significant impact on drug use among residents of this area. In addition, it will highly likely touch the question of distribution. Therefore, the most probable outcome of the bill implies reducing expenditures on prescription drugs.
In the article Cost-Sharing and Drug-Price Transparency in New York, Pope attempts to provide an in-depth insight into this issue. He highlights that purchasing prescription drugs has not been included in medical insurance covered due to considerations of its low prices (Pope, 2018). However, in the context of present-day development, this assumption does not match reality. Despite the attempt to improve the situation, patients are still required to pay for this aspect of treatment additionally (Pope, 2018). Pope (2018) claims: “whereas 2.6% of hospital inpatient spending was paid directly by patients in 2014, 13.9% of prescription drug costs were borne out-of-pocket” (p. 5). For instance, Figure 1 demonstrated the statistics of drug utilization in Florida in 2018. The graph matches the product names and the amount of the price covered by the Medicaid Program. As it can be noted, not all patients receive compensations for their prescription drug expenditures, which appears to be a negative fact in the context of rising prices.
Consequently, adherence to pricing transparency may contribute to the solution of the problem. Pope (2018) mentions that this approach may be helpful in avoiding significant expenditures on prescription drugs in the future. However, the author marks that it is essential to use it in the combination of deregulating cost-sharing and eliminating barriers to competition (Pope, 2018). Therefore, this method may be effective for minimizing the problem.
Another study, National Trends in Prescription Drug Expenditures and Projections for 2018, which is aimed to shed light on the topic of prices for prescription drugs. Schumock et al. (2018) presented data in this regard, according to which the sales comprised $455.9 billion. It is 1,7% higher, comparing to the figures for the previous year, which is demonstrated in Figure 2. Adalimumab insulin glargine, and etanercept occupied the first places in the rate of expenditures. Schumock et al. (2018) highlight: “Prescription expenditures in nonfederal hospitals totaled $34.2 billion, a 0.7% decrease in 2017 compared with 2016. Expenditures in clinics increased 10.9%, to a total of $70.8 billion” (para. 3). Thus, the authors noted an increase in purchasing prescription drugs on all levels, which is evident from Figure 2. Therefore, the Prescription Drug Pricing Transparency House Bill may be effective in the context of regulation money in this regard. It responds to the problem of rising prices for prescription drugs, which is not beneficial both for medical settings and patients.
The article The Drug (Pricing) Wars: States, Preemption, and Unsustainable Prices also explores this issue. Buck (2020) marks that the situation with drug pricing has deteriorated in recent years. The consequences of this tendency are negative, as it has a direct impact on accessibility to life-enhancing medications. Consequently, it threatens the quality of life of the population in the long run. As it is shown in Figure 3, the price for a similar drug may differ significantly. The graph demonstrates that some drugs may be twice more expensive, though the medication is the same.
Therefore, the necessity to change the policy in this regard is evident, and some states have taken steps in this direction. However, Buck (2020) does not regard the advanced measures as sufficient in order to address the problem comprehensively. The author claims: “applying lessons from the environmental law context, this piece challenges the wisdom and legitimacy of these federal regulatory clogs in the midst of a pharmaceutical drug cost crisis” (para. 5). In addition, Buck (2020) emphasizes the importance of elaborating new legislation in this regard, as its lack may prevent an obstacle for the solution of the problem. Consequently, new bills are effective, though they should be supported by other actions, and their power should be expanded.
Overpaying for Prescription Drugs: The Copay Clawback Phenomenon also contains an analysis of drug pricing. In order to examine this question thoroughly, Nuys et al. (2018) used pharmacy claims data and figures on national average drug reimbursements. According to Nuys et al. (2018), in 2013, 23% of patients had to pay additionally from prospection drug, and the sums were more than $2, taking into consideration average reimbursement. Nuys et al. (2018) counted the average overpayment, which comprised $7.69. Patients were commonly imposed on additional expenditures for purchasing generic brand drugs. Nuys et al. (2018) highlight: “in 2013, total overpayments amounted to $135 million in our sample, or $10.51 per covered life” (para. 1). As it is demonstrated in Figure 4, the least overpayment was $5.94 for sertraline hydrochloride, while the largest one was $19.95 for Ventolin HFA (albuterol sulfate). However, in case of considering the percentage of overpaying, zolpidem tartrate is at the top, as the percentage of claims involving overpayment for it was 60.49%.
This way, the authors draw attention to the pressing concern, associated with prescription pricing. Nuys et al. (2018) state that it is vital to change the focus of the government from innovative treatment methods to making medicine more affordable for the population. Otherwise, it may be harmful for the health of the citizenry and have a negative impact on the living conditions in the long term.
In conclusion, it can be mentioned that in the context of present-day development, Florida’s Prescription Drug Pricing Transparency House Bill 351 appears to be an essential step for improving the situation. The outcome of this legislation change may be beneficial and contribute to reducing expenditures on prescription drugs. The consequence may influence the use of drugs among patients. In case they are more affordable, individuals are highly likely to be more careful about their health. This will also be effective for enhancing an appropriate quality of life. However, it should be admitted that the current course is not sufficient to solve the problem comprehensively. It is vital to adhere to a combination of measures in order to provide a considerable change and improve the current situation with prospection drug pricing.
Buck, I. (2020). The drug (pricing) wars: states, preemption, and unsustainable prices. North Carolina Law Review, 393.
Nuys, K. V., Joyce, G., Ribero, R., & Goldman, D. P. (2018). Overpaying for prescription drugs: The Copay Clawback phenomenon.
Pope, C. (2018). Cost-sharing and drug-price transparency in New York. The Manhattan Institute.
Schumock, G. T., Stubbings, J., Wiest, M. D., Li, E. C., Suda, K. J., Matusiak, L. M., Hunkler, R. J., & Vermeulen, L. C. (2018). National trends in prescription drug expenditures and projections for 2018. American Journal of Health-System Pharmacy, 75(14), 1023–1038.
Figure 2. Expenditures on Prescription Drugs.
|The Data for 2017 Year||Comparing to 2016|
|Total U.S. prescription sales||$455.9 billion||+ 1,7%|
|Non-federal hospitals||$34.2 billion||+ 0.7%|
|Expenditures in clinics||$70.8 billion||10.9%|