Reducing the Cost of Prescription Drugs

By: Sen. Susan M. Collins

While driving with two of her sons in the car recently, Michelle Dehetre, a mother of five from Lewiston who has Type 1 diabetes, had a frightening experience that has become all too common for her: she began to feel very faint.  Fortunately, no one was injured, and paramedics quickly arrived on the scene to take her to the emergency room. 


Ms. Dehetre is one of the millions of Americans who have difficulty affording the medications they need to maintain their health.  Ms. Dehetre struggles to pay for the insulin she requires, and she cannot afford a continuous glucose monitor and pump that would help manage her diabetes, resulting in life-threatening emergencies virtually every month.


As Chairman of the Senate Aging Committee, I invited Ms. Dehetre to testify at a hearing on efforts to improve the affordability and accessibility of prescription drugs.  The March 6 hearing featured five patients, including Ms. Dehetre, who shared their stories to underscore the real-world effect that skyrocketing drug costs have on many Americans’ finances as well as their overall quality of life.  The following day, I chaired a Committee hearing with policy experts to examine ways to untangle the complex web of prescription drug prices.


“Ending up in the ER always scares me, not only because I know it’s a close call, but because on top of my medicine, I cannot afford another medical bill,” Ms. Dehetre told the Committee.  “The money I am spending on diabetes treatment already is too much.  In addition to buying food for six people, paying the electric bill, and covering rent, the $300 per month for my diabetes medicine is a major financial strain.”  Ms. Dehetre continuously worries that the next diabetic episode could be fatal and told the Committee, “My dream is to see my 11-year-old son graduate high school.”


For some conditions, prescription drugs represent a lifeline that allows individuals to live, breathe, eat, and sleep.  But in the face of rising costs, these therapies are becoming increasingly out of reach for some who need them most.  Prescription drugs don’t work for those who cannot afford to take them.  As Ms. Dehetre’s story demonstrates, Americans encounter tribulations every day because the drug they need carries a prohibitive price tag – causing them to stretch or skip doses, settle for an alternative that works poorly, or simply go without.  And her story echoes those I have heard from people throughout Maine – people with such conditions as heart disease, epilepsy, and multiple sclerosis – who simply cannot afford the medications they desperately need.


This year alone, Americans are expected to spend more than $360 billion on prescription drugs.  Of that, individuals will pay about $49 billion out-of-pocket, while the federal government will pick up another $163 billion in payments through Medicare, Medicaid, and other programs.


Addressing the rising costs of prescription drugs is among my top priorities.  In 2015, I launched the Senate’s first bipartisan investigation into the causes, impacts, and potential solutions to egregious price spikes for certain off-patent drugs.  Following that investigation, I co-authored a bill to improve generic competition and lower the cost of prescription drugs that was signed into law in 2017.


In October 2018, my legislation to prohibit pharmacy “gag clauses” was signed into law after passing both the House of Representatives and the Senate with overwhelming bipartisan support.  The Patient Right to Know Drug Prices Act and the Know the Lowest Price Act prohibit an egregious practice that concealed lower prescription drug prices from patients at the pharmacy and caused consumers to needlessly overpay.


And most recently, I introduced the Biologic Patent Transparency Act, a bill that would help make patents work as Congress intended.  The bill would shine a light on disturbing patent strategies that some manufacturers of expensive biologic therapies use to prevent lower-priced alternatives from coming to market.  By deterring patent abuse, this legislation would pave the path for new lower-cost alternatives.


The past century could be termed the Age of Miracle Drugs.  Today, however, we might define a ‘miracle drug’ as one that has not doubled in price since the last refill.  We must provide drug makers with the ability to recoup their investments in research and development, but at the same time, we cannot be blind to the costs of these drugs, nor to cases where patent laws are manipulated to preserve monopolies.