Capping prescription drug costs is not a substitute for lowering prices

April 25, 2022 6:45 am
Jar for prescription drugs stuffed with hundred dollar bill representing high cost health care

Photo illustration by Getty Images

Lawmakers in Congress have been promising to tackle rising drug prices for years, but so far there’s been little action. Now, Congress may be running out of time as bigger issues like the war in Ukraine and inflation crowd out long-standing issues with more immediate concerns.

The outrageous price of medicines has made prescription drug reform a top issue for years now as well as one that attracts bipartisan support. A recent poll showed that 91% of voters considered lowering drug prices a very important issue in the upcoming election, ranking it above COVID worries.

Of course, for millions, worry about affording prescriptions long preceded the pandemic crisis and the latest concerns about inflation. Drug corporations have been raising prices faster than inflation for years, while people of all ages struggle to keep up or are forced to choose between medicine and other basic necessities.

I have been HIV positive for over 15 years now. I am just as healthy as you as long as I take my medication every night. That medication retails for over $2,000 per month. The same medicine is sold in India for about $8 for a month’s supply. That’s only one example of how our pharmaceuticals industry values profits over people. I am fine — my insurance covers most of my cost — but I worry about the next man in my shoes and whether he might be as lucky.

It doesn’t matter if we drink from a water fountain or a bubbler, all Wisconsinites deserve the medicine they need to survive. Unfortunately, Big Pharma is pricing more Wisconsinites out of meds they need. We can have the affordable medication we deserve but only when we come together to tell our elected leaders in Washington, DC that simply living is too expensive in America — and that we need real relief from Big Pharma now. 

Millions of people like me are desperate for a solution to prescription drug price-gouging, but Congress doesn’t have multiple chances to get it right and patients have already waited too long. The time is now, while there is a majority of Senators who support tackling prices through negotiations in Medicare, to pass a bill that would finally put in place common sense reform that would address rising prices. 

Old ideas, like a national insulin price cap, are getting a fresh glow. Capping the cost of insulin is a worthy idea, especially as an interim measure to provide relief to seniors and diabetics, but it doesn’t address the real issues. Without negotiations that actually stop the drug corporations from charging whatever they want and raising prices at will, cost containment can only have limited impact for a limited number of patients while burdens continue to rise for the public, businesses, and those paying premiums. The toxic “Pharma Bro” culture in which CEOs reap big profits by setting prices that we are all forced to pay is dangerous. We survive based on our ability to afford our pills while Big Pharma just keeps raising the prices. 

The price of half the drugs in Medicare, thousands of commonly used medications, increased faster than inflation in 2020. Currently, there is no limit on what seniors pay out of pocket for drugs in Part D, forcing many to skip doses, not fill prescriptions or forgo other critical needs to get their medicines. Congress should fix that by acting to limit out-ofpocket drug costs for seniors, but they should also negotiate prices for medicines in Medicare the way other government agencies already do. Negotiated prices in the Department of Veterans Affairs and in Medicaid saves those programs and taxpayers that fund them substantially. Veterans Affairs and Medicaid pay half of what Medicare pays for prescription medicines thanks to negotiated prices.

We already know that negotiating prices will get consumers a better deal than continuing to give drug corporations monopoly power to set and keep their prices high. Monopoly power enables drug corporations to raise prices twice a year. In 2022 alone, drug corporations have already raised the price of over 800 medicines by more than 5%. Capping costs on insulin or any other drug is an important step toward affordability, but it doesn’t curtail drug corporations’ price-gouging. 

Fortunately, Congress has a solution: combine cost containment measures like an insulin cost cap and out-of-pocket cap for seniors in Medicare with policies that actually rein in rising costs, like Medicare negotiations and inflation caps, so we can stop drug corporations from raising prices faster than inflation. 

These proposals are all on the table right now as part of budget reconciliation, and have broad support among Democratic lawmakers, including Senator Tammy Baldwin. But we need Wisconsin’s whole delegation on board. It’s time to pass these reforms into law and make medicines affordable for everyone. 


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Ben Wilson
Ben Wilson

Ben Wilson is a City Council member in Viroqua, WI and the Driftless Co-Op Organizer with Citizen Action of Wisconsin. He is a dedicated advocate for lower drug prices, universal health care, clean water, and racial and economic justice.