Most of the time we associate medical debt with bills from doctors and hospitals, but for many Americans, the cost of prescription drugs is a major contributor to such debt. Whether it’s commonly used drugs that do not have generics available or so-called “wonder drugs” that can be life-saving but expensive, there is no doubt that medication costs are a growing concern for many.
Impact of Prescription Drugs on Medical Debt in Pennsylvania
In Pennsylvania, this problem is especially serious. In a recent survey, it was revealed that half of all Pennsylvania residents have struggled to afford healthcare in the last year. Additionally, 19% will forgo getting a prescription filled and another 17% will cut their pills in half or skip doses just so they can continue to afford the medication. And even more residents are worried about costs: two out of three are worried specifically about the cost of prescription drugs and almost 75% indicated that they felt prescription costs were a major contributor to the high cost of medical care.
Impact of Prescription Drugs on Medical Debt in the US
According to an article in USA Today, Americans borrowed in excess of $88 billion to pay for their medical bills and the US has the highest overall medical costs in the world, which should not come as a surprise considering the levels of medical debt across the nation. The Organisation for Economic Co-operation and Development reported that the average American spends a little over 12% of their medical costs on medication, including both prescription drugs and over-the-counter medications. While that is lower than other countries such as Russia at 29% or Japan at 20%, it is still a significant slice of healthcare costs. These levels of debt in this country are frightening and affect not just those without insurance, but the insured as well.
Real World Example of Tough Choices Involving Medications
On the website for the Department of Health and Human Services, you can find one person’s story about choosing between medical debt and prescription medications — a story all too familiar to many Americans. Sue Lee of Kentucky was on medication for plaque psoriasis while still employed and it was covered by her insurance so that her copay was only $60 per year. However, upon retiring and going on Medicare, that cost skyrocketed to $7,200 per year. Due to her limited income, Sue felt her only choice was to struggle through life without the medication that had truly controlled her condition. While many might point to a generic drug as the solution to such problems, not all prescription drugs have generics available (as in Sue’s case).
Why Prescriptions Cost So Much
So why do prescription medications cost so much? While generics are usually considered a low-cost alternative to name-brand medicines, not all medications have generics (for instance, until last year there were no low-cost generics for life-saving EpiPens) and some people may be sensitive to ingredients in the generic. In many instances, the physician has to approve a generic before it can be prescribed in place of the name-brand drug.
Another issue with prescription costs involves the “doughnut hole,” a term for the coverage gap that occurs when drug spending has reached a certain level. Once you fall into the doughnut hole, your prescription costs are out of pocket until you reach a certain maximum.
While many assume that the high cost of drugs is related to innovations and research, others point out it is actually due to the rising costs of existing drugs. In a report from CNBC, research revealed that costs for brand-name drugs were rising by about 9% annually, injected drugs saw costs increase by 15% annually, but inflation is only at 2% — which means that the cost of drugs is rising far more quickly than inflation. It has been suggested that prescriptions in the US cost so much because of a lack of regulation and a lack of competition. However, pharmaceutical companies argue that about 40% of the list price of medication is given as rebates or discounts to insurance companies, the government, or other entities that exist in the medical drug supply chain. These rebates and discounts rarely reach consumers, however.
The cost of medication accounts for a significant part of medical debt both for Pennsylvania residents and Americans in general. While it is very disturbing that people are going into debt or doing without their medications, no change seems likely any time soon. Pharmaceutical companies claim that these higher prices support research and innovation, but the costs of drugs are rising much faster than inflation. And these problems are affecting not just the uninsured but the insured as well — causing people to go into debt just to pay for the medications they need to survive.
Consumer Medical Bill Solutions
Are you overwhelmed by medical debt? There is no reason for you to continue with the shadow of medical debt hanging over you. Consumer Medical Bill Solutions can help you reduce your total medical debt by 25% to 45% (and sometimes even up to 75%). Our highly skilled staff will aggressively negotiate on your behalf to reduce your overall debt and stop the collection efforts against you. Our process is straightforward: fill out a contact form, talk with one of our team members, sign the necessary releases, provide us with your medical billing documentation, and then let us negotiate a settlement for you. Contact us today!