Have you ever looked beyond your copay to see the true cost of your medication? The next time you pick up a prescription, look at the total cost – the amount your insurance covers plus your share of the expense.  You will quickly discover that drugs are expensive! Most of my conversations with patients about drug prices included comments about being thankful that their insurance paid for part or all of the total cost.  We have entered a new age with more and more drugs becoming unaffordable, and Blue Cross and Blue Shield of Kansas is fighting back against these rising prices.

Few could argue the fact that we are living in an era of miraculous medication discoveries that provide new and improved treatments for diseases that can improve your life.  Unfortunately there also are dozens of products released each year by drug companies that provide little or no benefit over existing treatments but carry a cost hundreds of times more than generic products that have been used for years.

One known secret of drug manufacturers is to buy the rights of medications from other drug companies and then raise the prices.  It’s not uncommon to see prices increased by 500 percent or more.  You might remember last year when the price of a medication used to treat infections in HIV patients jumped 5,000 percent overnight.  Some of these products even have alternatives that can be purchased over the counter for much less.  The increased price is not derived from new innovation, so is it driven by profits?  One has to think so.

What can we do about these prices?  One answer is to hold manufacturers accountable for these price hikes by removing egregiously priced drugs from our list of covered drugs.  We consider coverage for these products after evaluating for efficacy and comparing the cost to other effective products.  Rest assured our formulary will continue to offer products with similar or better effectiveness.  This effort is to protect our members from wasteful drug spending in an attempt to save money for the medications that are life-saving.

Health care expenses are increasing, and we can help contain them by eliminating products with costs far exceeding that of other products offering similar or better efficacy.  Increased medical and prescription costs result in increased insurance premiums from year to year, and by controlling this spending we are doing what we can to transfer these savings back to our members.  Without these cost-conscious measures, premiums and other member cost-shares would wildly increase.  It’s frustrating when you see your own health care expenses continue to increase over time, but we will continue our efforts to keep your costs as low as possible.

Sources: The New York Times (Valeant) and The New York Times (Daraprim)

Tiffany Liesmann, BCBSKS staff pharmacist

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