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The U.S. passed a new version of their spending bill, but how will the bill's drug pricing reforms impact HIV patients?Guy Anthony is an author, HIV/AIDS activist, and president and CEO of Black, Gifted & Whole
Democrats in the United States just passed a new version of their spending bill just in time for August recess. I appreciate their sense of urgency – but I'm not convinced that the bill will actually bring real solutions to communities who need them, especially when it comes to the bill's drug pricing reforms.
As a Black queer man living with HIV, it's fair to say that I take special interest in lawmakers' attempts to lower drug prices.
But Democrats' latest effort to do so actually provides less relief to patients than past attempts. Our lawmakers need to redirect their efforts and focus on helping struggling Americans, especially those in minority communities that have long been victimized by healthcare inequities.
Prescription drug prices are far higher in the United States than in other high-income countries. These high costs also greatly contribute to healthcare inequity, as Black Americans are disproportionately affected by a number of health issues that require daily medication – including high blood pressure, diabetes, and HIV.
Overall, 26% of Americans have difficulty affording their medication.
Something must be done. However, the reforms Congressional Democrats just passed will come at a great cost to our most vulnerable communities.
The bill's main method to cut costs is government price controls on Medicare prescription drugs. Though it's being called government "negotiations" with drug makers, the bill makes clear that the government will simply dictate the price it's willing to pay for many life-saving medications on a take-it-or-leave-it basis.
That'll no doubt lead to some short-term savings – but it'll create an enormous problem for patients who suffer from diseases that are difficult or even currently impossible to treat, since price controls will disincentivize manufacturers and investors from pouring in the billions of dollars necessary to develop a new life-saving medication.
This will burden minority communities far more than whites.
For instance, the U.S. Department of Health and Human Services reports Hispanic women are 40% more likely to be diagnosed with cervical cancer. And though Black Americans account for 13% of the U.S. population, we make up 42% of new HIV diagnoses.
Drug innovation and development is imperative to health equity for our communities. The Democrats' spending bill will only set us back.
There are other options to lower drug costs and help vulnerable communities. Unfortunately, this bill doesn't include them.
Pharmacy benefit managers (PBMs) are the middlemen who negotiate drug prices with drug makers on behalf of insurance companies. PBMs obtain steep discounts in exchange for including drug companies' medications on various insurance plans.
But PBMs and insurers aren't required to pass these discounts along to patients at the pharmacy counter – so they don't. Forcing them to do so could save patients billions of dollars a year.
PBMs also restrict patient choice with regard to specific medications, which pharmacies to use, and delivery methods. All of these restrictions contribute much to the bottom lines of the PBM-insurer-pharmacy complex, but nothing to patient health or equity.
The spending package doesn't even attempt to address these PBM abuses.
Price controls will save the government money but deprive patients of lifesaving drugs in the long run. Instead of pressing forward with this misguided policy, lawmakers should have focused on delivering real relief at the pharmacy counter.
The bill won't deliver solutions in the way Democrats say it will – it will only make things worse for patients.
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