Skyrocketing Drug Prices Prompt Discussion of New Reimbursement Schemes

According to a publication from health website Stat, a new way of thinking about the price of drugs is taking root in Washington D.C. and beyond. “Value-based agreements” are a proposed means to set prices that drug manufacturers and customers alike are considering in the face of steeply climbing drug costs.

The situation in the United States has gotten so bad that some drugs are not feasibly affordable to the average citizen. Not just painkillers – these drugs can provide serious, life-altering benefits for thousands of people living with chronic illness. Conditions like hepatitis C, spinal muscular atrophy, and hemophilia all have treatments available that can make a meaningful difference to a patient’s prognosis.

Many Can’t Afford Care

Thousands of people in the United States will be bankrupted by a hospital bill this year. Many of these bankruptcies will be the result of unforeseeable emergencies like a bad car accident or other serious injury, but others will be the result of sustained debt forced onto a huge number of America’s chronically ill by skyrocketing drug costs and hospital fees.

Because many of the chronically ill patients can’t afford the drugs that could all too often save their lives, drug manufacturers are struggling to find a market for their products. In short, pharmaceutical companies are pricing themselves out of a market.

That’s the fear, anyway. Criticizing what they determine to be “antiquated” healthcare and reimbursement system, biopharmaceutical companies have started to suggest alternative payment plans in the wake of recent Senate Finance Committee hearings on drug pricing.

Pricing Plan Alternatives

One such model, the so-called “value-based agreement,” would have the biopharmaceutical company paid a flat fee for each dose of the treatment it delivered to a patient. The company would then pay back a percentage of that fee for patients that responded poorly or didn’t respond to the treatment. Theoretically, this model results in an overall reimbursement cost roughly equal to the drug’s overall worth to the public health.

Another potential pricing model was an installment method. There was no clever name for that plan because it’s exactly what it sounds like – patients would put a down payment down on a treatment, and continue making payments as long as positive results were experienced.

I don’t know about you, but these sound pretty dystopian to me. There’s a sizable divide between the needs of patients, government, and pharmaceutical companies of this country, and out-of-control drug prices are threatening to drive that wedge even deeper. No matter what the solution to drug pricing is, be it value-based, installment-based, or government-controlled, it must be found. Right now, people are suffering because of preventable high drug costs – and they’re being held hostage over a buck.

How do you think a balance should be struck between the prices pharmaceutical companies want to charge and what patients can afford? What’s the government’s role in mediating the discussion? Patient Worthy wants to hear from you!

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