Drug access and affordability

Patients should have access to the medications they need without burdensome costs. That’s why a comprehensive solution across the drug supply chain is needed to preserve access and address rising drug costs.

A variety of factors have affected patients’ access to treatment, including market forces that have led to consolidation of drug manufacturers, skyrocketing pricing of medications, and more.

Dermatologists are committed to providing the most effective and cost-efficient care and pharmaceutical therapies to their patients.

The Academy supports a multifaceted approach to fixing the drug cost crisis, including promoting transparency, removing barriers to generic alternatives, providing public notice of price hikes, and requiring more oversight of pharmacy benefit managers (PBMs). The AADA advocates to policymakers on drug pricing in alignment with the position statement, Patient Access to Affordable Treatments.

Below are some of the specific issues driving drug price increases.

Price transparency

The cost of a specific drug is often unknown to both physicians and patients until the patient is having their prescription filled. The Academy believes patients and physicians should have access to real-time cost information available at the point of prescribing to ensure cost considerations are a meaningful part of the decision-making process. The processes utilized in setting drug policies should be readily available and easy for patients to access. Further, formularies should be publicly available and easily accessible online.

The Academy supports legislation that requires transparency in insurance coverage policies for pharmaceuticals including co-payment and coinsurance levels, and information on how these levels are determined.

Generic drugs

Generic drugs can provide affordable alternatives for many patients and serve as a check on brand-name drug costs. But it is increasingly difficult to bring generic options to market.

The Academy supports removing barriers to the development and entry of generic drugs in the marketplace, which would help increase competition and lower prices of pharmaceuticals.

Price spikes

Sudden spikes in drug prices can cause unanticipated disruption in patient care, which can lead to worsening of a once stable chronic condition.

The Academy supports requiring pharmaceutical companies to provide justification and public notice before implementing price increases that substantially exceed the rate of inflation, and to provide a rationale for these price increases.

Pharmacy benefit managers (PBMs)

Pharmacy benefit managers (PBMs) function as middlemen that add cost and complexity to the pharmaceutical system, and they contribute to a lack of transparency in how drug prices and policies are set. Some PBMs may also have a conflict of interest when developing formularies or tiers.

The Academy supports PBM transparency, including disclosure of their current financial arrangements. The Academy also supports transparency in the drug price negotiation process of PBMs. Pharmaceutical manufacturers should publicly disclose discounts and rebates provided to PBMs, and PBMs should disclose how much of the rebates and discounts are passed on to patients.

Drug importation

The Academy supports drug importation proposals that would improve access to medications by increasing competition and lowering costs, while preserving safety and quality.